Академический Документы
Профессиональный Документы
Культура Документы
Ministry of Health
Victoria, BC
March, 2016
The Honourable Terry Lake
Minister of Health
Sir:
I have the honour of submitting the Provincial Health Officers Annual Report for 2011.
P.R.W. Kendall
OBC, MBBS, MHSc, FRCPC
Provincial Health Officer
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Table of Contents
LIST OF FIGURES AND TABLES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
ACKNOWLEDGEMENTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi
HIGHLIGHTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii
Chapter 1: INTRODUCTION TO ROAD SAFETY IN BC. . . . . . . . . . . . . . . . . . . . . . . 1
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Reimagining Road Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Governance of Roads and Road Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Methodology and Data Sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Data Analysis and Methodology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Data Sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Police Traffic Accident System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Discharge Abstract Database. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
BC Vital Statistics Agency. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Data Challenges and Limitations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
The Framework. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Population Health Approach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Public Health Approach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Public Health Triangle Model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
The Haddon Matrix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
A Safe System Approach to Road Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Road Use in Canada and BC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
MVC-related Fatalities and Serious Injuries in Canada and BC. . . . . . . . . . . . . . . . . . . 12
MVC-related Fatalities and Serious Injuries in Canada. . . . . . . . . . . . . . . . . . . . . . . . 13
MVC-related Serious Injuries and Fatalities in BC . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
The Cost of MVCs in Canada and BC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Organization of This Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
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Chapter 2
Figure 2.1 Number of Active Licenced Drivers and Motor Vehicle Crash Fatality Rate per 100,000 Active Licensed
Drivers, BC, 1994 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 2.2 Population Count and Motor Vehicle Crash Fatality Rate per 100,000 Population with Key Dates of Road
Safety Initiatives, BC, 1986 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 2.3a Proportion of Population and Motor Vehicle Crash Fatalities, by Health Authority, BC, 2012. . . . . . . . . . . .
Figure 2.3b Proportion of Population and Motor Vehicle Crash Fatalities, by Health Authority, BC, 2012. . . . . . . . . . . .
Figure 2.4 Age-standardized Motor Vehicle Crash Fatality Rate per 100,000 Population, by Health Authority,
BC, 2008-2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 2.5 Age-standardized Motor Vehicle Crash Hospitalization Rate per 100,000 Population,
by Health Authority, BC, 2006-2010. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 2.6 Number of Motor Vehicle Crash Fatalities, by Health Authority, BC, 2001 to 2012. . . . . . . . . . . . . . . . . . . .
Figure 2.7 Age-standardized Motor Vehicle Crash Fatality Rate per 100,000 Population, by Sex, BC, 1996 to 2013. . . .
Figure 2.8 Age-standardized Motor Vehicle Crash Hospitalization Rate per 100,000 Population, by Sex, BC,
2002 to 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Figure 2.9 Motor Vehicle Crash Fatality Rate per 100,000 Population, by Age Group, BC, 2002 to 2013. . . . . . . . . . . .
Figure 2.10 Motor Vehicle Crash Hospitalization Rate per 100,000 Population, by Age Group, BC, 2002 to 2011. . . . . .
Figure 2.11 Motor Vehicle Crash Fatality Rate per 100,000 Population,by Sex and Age Group, BC, 2009-2013 . . . . . . .
Figure 2.12 Motor Vehicle Crash Hospitalization Rate per 100,000 Population, by Sex and Age Group, BC,
2007-2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 2.13 Proportion of Motor Vehicle Crash Fatalities, by Top Contributing Factor, BC, 2008 to 2012 . . . . . . . . . . . .
Figure 2.14 Proportion of Population and Motor Vehicle Crash Fatalities for the Top Three Contributing Factors,
by Health Authority, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 2.15 Proportion of Motor Vehicle Crash Fatalities, by Top Contributing Factor and Sex, BC, 2008-2012. . . . . . . .
Figure 2.16 Proportion of Motor Vehicle Crash Fatalities, by Top Contributing Factor and Age Group, BC,
2008-2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Chapter 3
Figure 3.1
Figure 3.2
Figure 3.3
Figure 3.4
Figure 3.5
Figure 3.6
Figure 3.7
Figure 3.8
Figure 3.9
Figure 3.10
Figure 3.11
Figure 3.12
Figure 3.13
Figure 3.14
Figure 3.15
Figure 3.16
Table 3.1
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Proportion of Motor Vehicle Crash Fatalities, by Road User Type, BC, 2009-2013. . . . . . . . . . . . . . . . . . . .
Proportion of Motor Vehicle Crash Hospitalizations, by Road User Type, BC, 2007-2011. . . . . . . . . . . . . . .
Motor Vehicle Crash Fatality Rate per 100,000 Population, by Road User Type, BC, 2009 to 2013. . . . . . . .
Motor Vehicle Crash Hospitalization Rate per 100,000 Population, by Road User Type, BC,
2007 to 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Proportion of Motor Vehicle Crash Fatalities, by Road User Type, Greater Vancouver, 2009-2013. . . . . . . . .
Motor Vehicle Driver and Passenger Fatality Counts and Rates per 100,000 Population, BC,
1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Motor Vehicle Driver and Passenger Hospitalization Count and Rate per 100,000 Population, BC,
2002 to 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Motor Vehicle Crash Average Annual Driver Fatality Rate per 100,000 Driver Population, by Sex
and Age Group, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Motor Vehicle Crash Passenger Fatality Rate per 100,000 Population, by Sex and Age Group, BC,
2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Motor Vehicle Driver and Passenger Hospitalization Rate per 100,000 Population, by Sex
and Age Group, BC, 2007-2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Proportion of BC Population and Motor Vehicle Crash Fatalities, by Age Group, BC, 2009-2013. . . . . . . . .
Heavy Commercial Vehicle Crash Rate per 100,000 Licenced Heavy Commercial Vehicles, BC,
2003 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fatalities from Motor Vehicle Crashes Involving a Commercial Vehicle, Count and
Rate per 100,000 Population, BC, 1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Proportion of Fatalities Involving a Commercial Vehicle, by Road User Type, BC, 2009-2013. . . . . . . . . . . .
Motor Vehicle Crashes Involving a Commercial Vehicle, Fatality Rate per 100,000 Population,
by Sex and Age Group, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rural and Urban Seat Belt Non-use, BC and Canada, 2009-2010. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Motor Vehicle Crash Patient Count, Proportion and Mean Hospital Stay, by Restraint Use and Urban
or Rural Location, BC, 2001-2008. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Chapter 4
Figure 4.1 Proportion of Total Motor Vehicle Crash Fatalities, by Vulnerable Road User Type, BC, 2009 to 2013. . . . . .
Figure 4.2 Proportion of Total Motor Vehicle Crash Hospitalizations, by Vulnerable Road User Type, BC,
2007 to 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.3 Proportion of Population and Motor Vehicle Crash Fatalities, by Vulnerable Road User Type
and Health Authority, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.4 Motor Vehicle Crash Motorcycle Occupant Fatality Count and Rate per 100,000 Population,
BC, 1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.5 Motor Vehicle Crash Motorcycle Occupant Hospitalization Count and Rate per 100,000 Population,
BC, 2002 to 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.6 Motor Vehicle Crash Motorcycle Occupant Fatality Rate per 100,000 Population, by Sex and Age
Group, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.7 Motor Vehicle Crash Motorcycle Occupant Hospitalization Rate, by Sex and Age Group, BC,
2007-2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.8 Motor Vehicle Crash Cyclist Fatality Count and Rate per 100,000 Population, BC, 1996 to 2013. . . . . . . . .
Figure 4.9 Motor Vehicle Crash Cyclist Hospitalization Count and Rate per 100,000 Population, BC, 2002 to 2011. . .
Figure 4.10 Motor Vehicle Crash Cyclist Fatality Rate per 100,000 Population, by Sex and Age Group, BC,
2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.11 Motor Vehicle Crash Cyclist Hospitalization Rate per 100,000 Population, by Sex and Age Group,
BC, 2007-2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.12 Sample of Infrastructure Measures to Increase Cyclist Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.13 Motor Vehicle Crash Pedestrian Fatality Count and Rate per 100,000 Population, BC, 1996 to 2013 . . . . . .
Figure 4.14 Motor Vehicle Crash Pedestrian Hospitalization Count and Rate per 100,000 Population, BC,
2002 to 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.15 Motor Vehicle Crash Pedestrian Fatality Rate per 100,000 Population, by Sex and Age Group, BC,
2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 4.16 Motor Vehicle Crash Pedestrian Hospitalization Rate per 100,000 Population, by Sex and Age Group,
BC, 2007-2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Chapter 5
Figure 5.1 Distraction-related Motor Vehicle Crash Fatality Count and Rate per 100,000 Population, BC,
2004 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 5.2 Distraction-related Motor Vehicle Crash Fatality Rate per 100,000 Population, by Sex and Age Group,
BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 5.3 Age-standardized Distraction-related Motor Vehicle Crash Fatality Rate per 100,000 Population,
by Sex, BC, 2004 to 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 5.4 Electronic Device Warning Signage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 5.5 Relative Risk of Fatal Motor Vehicle Crash, by Blood Alcohol Content Level and Age Group. . . . . . . . . . . . .
Figure 5.6 Impaired-related Motor Vehicle Crash Fatality Count and Rate per 100,000 Population, BC,
1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 5.7 Age-standardized Impaired-related Motor Vehicle Crash Fatality Rate per 100,000 Population,
by Sex, BC, 1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 5.8 Impaired-related Motor Vehicle Crash Fatality Rate per 100,000 Population, by Sex and
Age Group, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Table 5.1
Table 5.2
Table 5.3
Distraction-related Motor Vehicle Crashes and Fatalities, by Year, BC, 2008 to 2012. . . . . . . . . . . . . . . . . . . 87
Number and Proportion of Sleep and Medication Impaired-related Motor Vehicle Crash Fatalities,
by Impairment Type, BC, 2008-2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Number and Proportion of High-risk Driving-related Motor Vehicle Crash Fatalities,
by Behaviour Type, BC, 2008-2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Chapter 6
Figure 6.1 Speed-related Motor Vehicle Crash Fatality Count and Rate per 100,000 Population, BC,
1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 6.2 Proportion of Speed-related Motor Vehicle Crash Fatalities, by Road User Type, BC, 2009-2013. . . . . . . . .
Figure 6.3 Speed-related Motor Vehicle Crash Fatality Rate per 100,000 Population, by Sex and Age Group,
BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 6.4 Age-standardized Speed-related Fatality Rate per 100,000 Population, by Sex, BC, 1996 to 2013. . . . . . . .
Figure 6.5 Sample of Signage in BC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Table 6.1
Table 6.2
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Number and Proportion of Speed- and Impairment-related Motor Vehicle Crash Fatalities, BC,
2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Survivable Speed and Road Type, by Road User and Motor Vehicle Crash Type. . . . . . . . . . . . . . . . . . . . . . 116
Chapter 7
Figure 7.1 Potential Conflict Points at Intersections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 7.2 Motor Vehicle Crash Fatalities at Intersections, Count and Rate per 100,000 Population, BC,
1996 to 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 7.3 Proportion of Motor Vehicle Crash Fatalities at Intersections, by Road User Type, BC, 2009-2013. . . . . . .
Figure 7.4 Pedestrian Fatality Rate per 100,000 Population for Motor Vehicle Crashes at Intersections,
by Sex and Age Group, BC, 2009-2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 7.5 Top Five Environmental Contributing Factors in Fatal Motor Vehicle Crashes, BC, 2008-2012. . . . . . . .
Figure 7.6 Number of Environment-related Motor Vehicle Crash Fatalities, BC, 2001 to 2012. . . . . . . . . . . . . . . .
Figure 7.7 Example of Provincial Highway Cycling Routes Signage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 7.8 Example of a Pedestrian Scramble. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 7.9 Selection of Rumble Strips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 7.10 Regulatory Signs for Winter Tires. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Chapter 8
Figure 8.1
Figure 8.2
Figure 8.3
Figure 8.4
Figure 8.5
xiv
Proportion of Motor Vehicle Crash Fatalities, by Vehicle Type, BC, 2008 to 2012 . . . . . . . . . . . . . . . . . . . .
Vehicle Crash Incompatibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Distribution of Light Vehicles, by Body Type, Canada, 2000 and 2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Top Four Vehicle Condition Contributing Factors in Fatal Motor Vehicle Crashes, BC, 2008-2012. . . . . . .
Age Distribution of Vehicle Fleets, by Vehicle Type, Canada, 2009. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
143
144
145
152
154
Chapter 9
Figure 9.1 Distribution of the Aboriginal Population, by Health Authority, BC, 2006. . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.2 Aboriginal Population as a Percentage of the Total Population, by Health Authority, BC, 2006. . . . . . . . . . .
Figure 9.3 Age-standardized Motor Vehicle Crash Fatality Rate per 100,000 Population for Status Indians
and Other Residents, BC, 1993 to 2006. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.4 Potential Years of Life Lost Standardized Rate per 100,000 Population for Status Indians and
Other Residents, by Cause of Death, BC, 2002-2006. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.5 Age-standardized Hospitalization Rate per 100,000 Population for Status Indians and
Other Residents, by External Cause, BC, 2004/2005-2006/2007. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.6 Age-standardized Motor Vehicle Crash Fatality Rate per 100,000 Population for Status Indians and
Other Residents, by Health Authority, BC, 2002-2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.7 Potential Years of Life Lost Standardized Rate per 100,000 Status Indian Population due to
Motor Vehicle Crashes, by Health Authority, BC, 2002-2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.8 Fatality Rate per 100,000 Population among Children Age 1-4 Years for Status Indians and
Other Residents, by Cause of Death, BC, 1992-2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Figure 9.9 Percentage of Youth On- and Off-reserve Who Always Wore a Seat Belt When Riding in a Vehicle,
BC, 2003, 2008, and 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
159
160
164
165
166
167
167
168
170
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xv
Acknowledgements
Acknowledgements
This report represents a large-scale, collaborative effort that has spanned numerous years and iterations. The Provincial
Health Officer (PHO) is grateful to the many analysts, researchers, writers, project managers, and experts who have
contributed to, or reviewed, drafts of this report over the years. While not all content contributions can be included, the
input received was vital in the development of the final report.
This report is dedicated to the work of former Deputy PHO, Dr. Eric Young. His passion and dedication to improving
road safety in BC were essential to the development of this report.
xvi
Denis Boucher
Officer in Charge
E-Division, Traffic Services
Royal Canadian Mounted Police
Dr. Jeff Brubacher
Associate Professor
Department of Emergency Medicine
University of British Columbia
Dr. John Carsley
Medical Health Officer
Vancouver Coastal Health
Dr. Herbert Chan
Researcher
Department of Emergency Medicine
University of British Columbia
Acknowledgements
Lisa Lapointe
Chief Coroner
BC Coroners Service
BC Ministry of Public Safety and Solicitor General
Dr. Andrew Larder
Medical Health Officer
Fraser Health Authority
Dr. Victoria Lee
Chief Medical Health Officer
Fraser Health Authority
Dr. Marcus Lem
Medical Health Officer
Fraser Health Authority
Dr. Gord Lovegrove
Associate Professor
Faculty of Applied Science, School of Engineering
University of British Columbia Okanagan
Dr. James Lu
Medical Health Officer
Vancouver Coastal Health
Dr. Mark Lysyshyn
Medical Health Officer
Vancouver Coastal Health
Sam MacLeod
Superintendent of Motor Vehicles
RoadSafety BC
BC Ministry of Public Safety and Solicitor General
Dr. Paul Martiquet
Medical Health Officer
Vancouver Coastal Health
Matt Herman
Executive Director
Healthy Living and Health Promotion
Population and Public Health
BC Ministry of Health
Richard Mercer
Research Officer
Office of the Provincial Health Officer
BC Ministry of Health
Clint Kuzio
(former) Director
Aboriginal Health Directorate
BC Ministry of Health
Megan Misovic
(former) Project Director
Aboriginal Health Directorate
BC Ministry of Health
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xvii
Acknowledgements
Dr. Lisa Mu
Medical Health Officer
Fraser Health Authority
Dr. Michelle Murti
Medical Health Officer
Fraser Health Authority
Tara Nault
Director, Aboriginal Health
Rural, Remote and Aboriginal Health
BC Ministry of Health
Ken Ohrn
Photographer
Cypress Digital
Dr. Shovita Padhi
Medical Health Officer
Fraser Health Authority
Mike Pennock
Population Health Epidemiologist
Office of the Provincial Health Officer
BC Ministry of Health
Kathleen Perkin
Manager, Harm Reduction Policy
Population and Public Health
BC Ministry of Health
Dr. Ian Pike
Director
BC Injury Research and Prevention Unit
Child and Family Research Institute
Dr. Sue Pollock
Medical Health Officer
Interior Health Authority
Fahra Rajabali
Researcher and Data Analyst
BC Injury Research and Prevention Unit
Child and Family Research Institute
Kim Reimer
Economist
Office of the Provincial Health Officer
BC Ministry of Health
xviii
Tej Sidhu
Manager, Policy, Research and Systems
BC Coroners Service
BC Ministry of Public Safety and Solicitor General
Will Speechley
Research Officer
BC Coroners Service
BC Ministry of Public Safety and Solicitor General
Dr. Richard Stanwick
Chief Medical Health Officer
Vancouver Island Health Authority
Jan Staples
Director, Road Safety Unit
Police Services Division
BC Ministry of Public Safety and Solicitor General
Dr. Helena Swinkels
Medical Health Officer
Fraser Health Authority
Dr. Kay Teschke
Professor
School of Population and Public Health
University of British Columbia
Dr. Gerald Thomas
Director, Alcohol and Gambling Policy
Population and Public Health
BC Ministry of Health
Shannon Tucker
Program Manager, Road Safety Unit
Police Services Division
BC Ministry of Public Safety and Solicitor General
Dr. Kenneth Tupper
Director, Problematic Substance Use Prevention
Population and Public Health
BC Ministry of Health
Acknowledgements
Marc Alexander
Royal Canadian Mounted Police
Glenyth Caragata
Insurance Corporation of BC
Barbara Carver
BC Ministry of Health
* This information reflects affiliation at the time of contribution, which may not be the same as an individuals current organization.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xix
Acknowledgements
Mike Diak
Royal Canadian Mounted Police
Miranda Kelly
First Nations Health Authority
Teresa Dobmeier
Interior Health Authority
Debra Kent
Drug and Poison Information Centre
Eric Kowalski
Interior Health Authority
David Dunne
Insight Driving Solutions
Ted Emanuels
Royal Canadian Mounted Police
Denise Foucher
Northern Health Authority
Dr. Murray Fyfe
Vancouver Island Health Authority
Joe Gallagher
First Nations Health Council
Norm Gaumont
Royal Canadian Mounted Police
Nancy Letkeman
RoadSafety BC
Jamie Graham
Victoria Police Department
Steve Martin
RoadSafety BC
Jim Gross
Highway Safety Roundtable
Alyson McKendrick
Safe Start, BC Childrens Hospital
Nial Helgason
Interior Health Authority
Jeff Moffett
Contractor
Karen Horn
Safe Start, BC Childrens Hospital
Pamela Morrison
First Nations Health Authority
Nicolas Jimenez
Insurance Corporation of BC
Glen Nicholson
Advocate Electronic Stability Control
Mavis Johnson
Canadian Traffic Safety Institute
Mark Ordeman
WorkSafeBC
Catherine Jones
Provincial Health Service Authority
Magda Kapp
BrainTrust Canada Association
xx
Acknowledgements
Doug Rankmore
Brain Trust Canada
Meridith Sones
BC Coroners Service
Dan Riest
Centre for Addictions Research BC
Shannon Stone
First Nations Health Authority
Melanie Rivers
First Nations Health Authority
Dana Tadla
RoadSafety BC
Pierre Thiffault
Canadian Council of Motor Traffic Administrators
Manik Saini
BC Ministry of Health
Kyle Todoruk
BC Ministry of Health
Jat Sandhu
Vancouver Coastal Health Authority
Amy Schneeberg
(contracted by) BC Injury Research and Prevention Unit
Giulia Scime
BC Injury Research and Prevention Unit
Janis Urquhart
Vancouver Island Health Authority
Lori Wagar
BC Ministry of Healthy Living and Sport
Samantha Scott
RoadSafety BC
Sonny Senghera
Insurance Corporation of BC
Joy Sengupta
BC Ministry of Transportation and Infrastructure
Sukhy Sidhu
BC Ministry of Health
Leonard Sielecki
BC Ministry of Transportation and Infrastructure
Joelle Siemens
RoadSafety BC
Kate Turcotte
BC Injury Research and Prevention Unit
Gurjeet Sivia
Fraser Health Authority
Frank Wright
Capital Reional District Integrated Road Safety Unit
Dorry Smith
BC Injury Research and Prevention Unit
Louise Yako
BC Trucking Association
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xxi
Acknowledgements
Robin Yates
(former) Project Manager, Injury Prevention Analyst
Population and Public Health
BC Ministry of Health
xxii
Highlights
Highlights
This report explores road safety in BC using
a comprehensive safe system framework
that includes the pillars of a Safe System
Approach (SSA)safe road users, safe
speeds, safe roadways, and safe vehicles
in combination with a population health
approach and a public health approach. The
report explores each of the four pillars of the
SSA, including technologies and strategies
for improving road safety related to road
user behaviours and conditions, speed limits,
vehicle technologies, and roadway design and
infrastructure. The report aims to support
and advance the health of the BC population
as a whole, while examining sub-populations
that face a greater burden of motor vehicle
crash (MVC) serious injuries and fatalities.
Analyses explore data according to road user
type, age, sex, and health authority area.
Analyses presented also examine road safety
for Aboriginal peoples and communities. The
report concludes with 28 recommendations
for reducing the burden of MVCs and
improving road safety in BC.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xxiii
Highlights
MVC Trends in BC
Among BC health authorities,
proportionately more MVC fatalities
occur in Northern Health and
Interior Health than their respective
proportions of the BC population. In
2012,Northern Health had 6.3 per cent
of thepopulation, but 13.5 per cent of
MVC fatalities in BC occurred there;
Interior Health had 15.9 per cent of the
population but 38.8 per cent of MVC
fatalities in BC.
For 2008-2012, MVC fatality rates were
18.0 per 100,000 population in Northern
Health and 16.3 per 100,000 in Interior
Healthboth much higher than the BC
average of 6.9 per 100,000. Vancouver
Coastal had the lowest rate for that period
at 2.3 per 100,000.
Analyses based on age group show that
for 2002 to 2013 there were decreases
in MVC fatality rates across all age
groups, but those aged 16-25 and 76 and
up continue to have the highest MVC
fatality rates per 100,000 population.
Similarly, those two age groups had the
highest MVC serious injury rates per
100,000 from 2002 to 2011.
Age-standardized MVC fatality rates for
males and females in BC for 1996 to
2013 show that the rate for males was
more than double the rate for females for
the majority of years, although a greater
decline in the rate for males has narrowed
the gap somewhat in recent years.
The top human contributing factors
for MVCs with fatalities that were
reported by police in BC between 2008
and 2012 were speed, impairment, and
distraction. In 2012, speed was the top
factor, associated with 35.7 per cent of
MVC fatalities, followed by distraction
(28.6 per cent of MVC fatalities), and
impairment (20.4 per cent of MVC
fatalities).
xxiv
Highlights
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xxv
Highlights
xxvi
Speed-related MVCs in BC
There is an established and expanding
body of research showing a clear
relationship between safe speeds and road
safety. This is founded on two main facts:
as speed increases, reaction time decreases;
and physical force increases with speed,
resulting in an exponentially increasing
risk of serious injury or death in an MVC.
Highlights
Safe Roadways
The number and rate of MVC fatalities at
intersections in BC decreased overall from
1996 to 2010, but the rate has increased
slightly since that time. Vulnerable road
users were the most likely fatal victims at
intersections for 2009-2013, making up
53.3 per cent of intersection fatalities.
In BC for 2008-2012, 32.9 per cent of
MVC fatalities occurred on highways
with posted speed limits of 90 km/hr or
higher.
MVCs are more commonly fatal in rural
areas because of relatively high travel
speeds, increased interaction between
non-commercial and commercial vehicles,
longer emergency response times, and
further distances to hospitals.
53.3%
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xxvii
Highlights
Safe Vehicles
From 2000 to 2009, the proportion
of light vehicles on the road that were
cars decreased from 60.5 per cent to
55.4percent; during the same time
period, the proportion of sport-utility
vehicles nearly doubled from 6.9 per cent
to 12.8percent.
Additionally, during this time sub-compact
and mini-compact vehicles (both very
small vehicle types) were introduced by
vehicle manufacturers. As a result of these
changes, vehicle crash incompatibility in
Canada has become more pronounced,
with the different shapes and sizes, and
frame-to-frame misalignment resulting in
increased risk of injury or death for vehicle
occupants (usually for the occupants
of the smaller vehicle). After-market
modifications (such as raising vehicles
or adding bull bars) also create and/or
exacerbate vehicle crash incompatibility.
xxviii
Highlights
18.8 per
100,000
7.1 per
100,000
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
xxix
Highlights
SOLUTIONS
Over the last two decades BC has achieved
many gains in advancing road safety
and reducing the burden of MVCs. By
continuing to improve infrastructure,
vehicle designs, speed-related safety
measures, and road user behaviours and
conditionsparticularly with a focus on
vulnerable road users, BC can achieve
even lower death and injury rates. These
improvements would also foster more active
and ecologically friendly transportation
improving both human and environmental
health. The 28recommendations offered
in this report aim to address challenges to
road safety while building upon our current
successes. These recommendations highlight
xxx
Chapter 1
Bolded text throughout this report indicate glossary terms, which are defined in Appendix A.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
Figure
1.1
Projected
increase
without action
2.0
1.8
1.6
1.4
1.2
1.0
0.8
0.6
Projected
reduction if
action taken
0.4
0.2
0
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Year
Source: Adapted from Fia Foundation. Make Roads Safe. A Decade of Action for Road Safety10 and World Health Organization.
2013. Global Status Report on Road Safety: Time for Action11.
The current situation is a system failure. Because safety has not been the starting
point for the design of the system, what we now have is an untreated public
health problem. In many other areas of public policy, we simply do not tolerate
such consistent levels of unmanaged human harm.
N. Arason, No Accident: Eliminating Injury and Death on Canadian Roads 14(p.3)
CRSS 2015 is Canadas third national road safety strategy and spans five years (20112015). Canadas first road safety strategy,
Road Safety Vision 2001, was released in 1996. It was followed by Road Safety Vision 2010 in 2000.
b
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
Data Sources
Data for this report were obtained from a
variety of primary and secondary sources.
Primary data presented in this report were
obtained from three main sources:
(1) the Police Traffic Accident System (TAS)
database from ICBCs Business Information
Warehouse; (2) the Discharge Abstract
Database (DAD) from the BC Ministry
of Health; and (3) the BC Vital Statistics
Agency (VSA) statistical database at the
Ministry of Health. These three sources are
discussed in this section. Some additional
data were provided by the BC Trauma
Registry, BC Coroners Service, BC Ministry
of Transportation and Infrastructure, BC
Ministry of Justice (RoadSafetyBC), Statistics
Canada, Transport Canada, and WorkSafe BC.
Some of these reports are accessible via the website of the Office of the Provincial Health Officer (www.health.gov.bc.ca/pho/reports).
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
The recognition that any level of serious trauma arising from the road
transport system is ultimately unacceptable, and that the system should
be designed to expect and accommodate human error, is relatively new
in road safety. These views have long been held in other transport and
infrastructure systems, such as air transport or the distribution of domestic
electricity. In these environments elaborate protection strategies have
been developed; the manager of the system responds to crashes and other
incidents by making systemic improvements, and the leaders of the system
expect a failsafe system and prioritise activity and resources accordingly.
Organisation for Economic Co-operation and Development, Towards Zero:
Ambitious Road Safety Targets and the Safe System Approach 6
THE FRAMEWORK
To best examine the complex topic of road
safety and MVCs and to highlight the
importance of a comprehensive and multisectoral approach to injury prevention, this
report integrates three key approaches into
its framework: a population health approach,
a public health approach, and an SSA.
Figure
1.2
Agent
Host
Environment
Table
1.1
FACTORS
OPPORTUNITY
FOR PREVENTION
Road User
Vehicle
Roadway
Before Crash
(Crash prevention)
Attitudes
Information
Impairment
Enforcement
Handling
Roadworthiness
Lighting
Speed management
Braking
Crash avoidance technologies
Electronic stability control
Crash
(Injury prevention
during crash)
Restraint use
Speed at impact
Impairment
Kinetic energy-absorbing
roadside objects
After Crash
(Sustaining life)
Rescue services
Time to medical care
Congestion
Source: Adapted from Organisation for Economic Co-operation and Development. Towards Zero: Ambitious Road Safety Targets and the Safe System
Approach,6(p.71) and Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, et al. 2004. World Report on Road Traffic Injury Prevention.7(p.13)
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
WA
TI
AG E M E
NT
Y
NIT
&F
ENG
NS
IR
O
U
RI
AT I O N C O M M
SE
D
N
OA D
W AY S F
TH A
REE OF DEA
NNOV
AT
IO
SAF
RIE
ERS
JU
SAFE
US
IN
VE
AN
TO
ER
DATA
NF
AF
EN
AND
DE
SS
EM
E
CH
RO
AN
RC
ER
ION
AD
TH
IP
Human
tolerance
to physical
force
SAFE
L E G I S L AT
RD
SAF
SH
AR
ES
ICL
DER
EED
EDUC A
TION
SP
VERN
ADS
EN
GO
DA
AR
S
ES
O R K I N G TO
RS W
GE
SE
PA
NE
RT
TN
1.3
RO
Figure
US
Source: Reproduced with permission from BC Ministry of Justice. 2013. British Columbia Road Safety Strategy 2015 and Beyond.3
10
Figure
1.4
Public Transit
Driver of Car,
Truck, or Van
12.6%
71.3%
Walk
6.7%
5.6%
Passenger of
Car, Truck, or Van
2.1%
Bicycle
1.7%
Other
Note: See Appendix B for more information about this data source.
Source: Statistics Canada, 2011 Census of Population. Prepared by Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
11
Figure
1.5
350,000
Number of Drivers
300,000
250,000
200,000
150,000
100,000
50,000
0
Male
16-25
26-35
36-45
46-55
56-65
66-75
223,000
277,000
277,000
320,000
292,000
188,000
76+
Total
97,000
1,675,000
Female
208,000
272,000
280,000
318,000
287,000
174,000
80,000
1,619,000
Total
430,000
550,000
557,000
639,000
579,000
362,000
178,000
3,297,000
Age Group
Note: "Drivers" include those who currently hold an active BC drivers licence. Not all individuals who hold a driver's licence own or operate vehicles in
BC. Counts have been rounded to the nearest thousand. Totals are rounded, but calculated based on unrounded numbers. There were 3,000 cases
where age group and/or sex was missing, and these cases are excluded from this figure. See Appendix B for more information about this data source.
Source: Business Information Warehouse, Insurance Corporation of British Columbia, data as of September 30, 2014. Prepared by BC Injury Research
and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
12
Fatality and injury numbers are calculated based on a five-year average for 2009-2013.
Figure
1.6
4.4
4.3
4.1
4.1
3.9
3.5
3.3
3.0
3.0
2.8
2.9
13.4
12.7
12.4
11.4
11.4
10.8
10.0
9.7
7.1
6.9
6.9
6.5
6.3
6.3
6.1
6.0
5.8
5.8
4.7
5.7
6.8
9.1
10
9.2
12
10.7
14
2.8
16
Jurisdiction
Note: Fatality includes death within 30 days of the crash. Numbers are based on police recorded data (except the Netherlands). See Appendix B for more information about this data source.
Source: International Traffic Safety Data and Analysis Group. 2014. Road Safety Annual Report: Summary.45 Prepared by Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
13
1.7
18.4
15.7
18
13.4
16
14
12
7.8
7.7
7.7
7.2
7.1
6.5
5.9
5.6
5.6
5.2
5.0
3.6
3.6
3.4
3.4
3.3
4.7
4.9
6.9
10
2.9
20
2
0
Jurisdiction
Note: Fatality includes death within 30 days of the crash. Numbers are based on police recorded data (except the Netherlands). Comparisons of
vehicle-kilometres shown here should be interpreted with caution, as these data may not be consistently measured across international jurisdications. See
Appendix B for more information about this data source.
Source: International Traffic Safety Data and Analysis Group. 2014. Road Safety Annual Report: Summary.45 Prepared by Population Health Surveillance,
Engagement and Operations, Ministry of Health, 2015.
14
Figure
1.8
12,000
500,000
450,000
Number of People
350,000
8,000
300,000
250,000
6,000
200,000
4,000
150,000
100,000
10,000
400,000
2,000
50,000
0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Number of People
439,000
435,000
427,000
428,000
434,000
450,000
469,000
459,000
446,000
429,000
432,000
439,000
Involvement Rate
10,768.0
10,609.3
10,354.2
10,300.8
10,343.8
10,609.0
10,929.9
10,553.2
10,111.8
9,606.1
9,601.8
9,664.3
Year
Note: "People" includes drivers, passengers, pedestrians, and cyclists involved in a motor vehicle crash (MVC) regardless of injury or fatality. Counts have
been rounded and do not include people involved in an MVC that was not reported to the Insurance Corporation of British Columbia. See Appendix B for
more information about these data sources.
Sources: Motor vehicle crash data are from the Business Information Warehouse, Insurance Corporation of British Columbia, 2001-2012; population
estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance,
Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
15
Figure
1.9
16.8
16
14
12
10
Manitoba
8.9
Prince Edward
Island
8.8
7.7
Newfoundland
and Labrador
7.6
Quebec
New
Brunswick
Nova Scotia
Alberta
6.2
5.3
5.2
8.6
Average (6.0)
4.2
18
2
0
Ontario
British
Columbia
Saskatchewan
Province
Note: Northwest Territories, Yukon, and Nunavut have been omitted due to unreliable reporting. Data for Ontario were preliminary. Data for
Newfoundland and Labrador, and New Brunswick were estimated. See Appendix B for more information about this data source.
Source: Transport Canada, Canadian Motor Vehicle Collision Statistics, 2012. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
16
Figure
1.10
900
842.1
700
664.9
Average (475.3)
600
492.8
British
Columbia
483.3
444.5
Ontario
468.5
442.3
300
392.1
400
438.8
500
375.4
800
Alberta
Quebec
Nova Scotia
200
100
0
New
Brunswick
Saskatchewan
Manitoba
Province
Note: Northwest Territories, Yukon, and Nunavut have been omitted due to unreliable reporting. Data for Ontario were preliminary. Data for
Newfoundland and Labrador, and New Brunswick were estimated. Changes in how motor vehicle crash reports are collected in Manitoba resulted in an
increased number of minor injuries being captured in these data compared to previous years. See Appendix B for more information about this data source.
Source: Transport Canada, Canadian Motor Vehicle Collision Statistics, 2012. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
17
Figure
1.11
450
12
Number of Fatalities
400
10
350
300
250
6
200
150
100
2
50
0
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Number of Fatalities
469
429
429
409
-396
394
457
448
440
452
402
411
354
363
364
292
280
269
Fatality Rate
12.1
10.9
10.8
10.2
9.8
9.7
11.1
10.9
10.6
10.8
9.5
9.6
8.1
8.2
8.2
6.5
6.2
5.9
Year
Note: See Appendix B for more information about these data sources.
Sources: Fatality counts are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
18
14
500
Figure
1.12
120
4,500
Number of Hospitaiizations
4,000
100
3,500
80
3,000
2,500
60
2,000
40
1,500
1,000
20
500
0
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Number of Hospitalizations
3,959
3,932
3,944
3,864
3,931
3,804
3,673
3,466
3,312
3,038
Hospitalization Rate
96.6
95.3
94.9
92.1
92.7
88.7
84.4
78.6
74.2
67.5
Year
Note: See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations,
Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
19
Figure
1.13
$200
Ontario
Manitoba
$137.00
Prince Edward
Island
$128.00
$109.00
Newfoundland
and Labrador
$123.00
$60
$93.00
$80
$92.00
$100
$104.00
$120
$122.00
$140
$148.00
Average ($116.90)
$160
$187.00
$180
$40
$20
$0
Nova Scotia
Quebec
New
Brunswick
British
Columbia
Saskatchewan
Alberta
Province
Note: Total cost per capita includes direct costs (the value of resources used to treat the persons in motor vehicle crashes) and indirect costs (the value
lost to society as a result of the motor vehicle crash). "Transport-related injuries" include incidents with pedestrians, pedal cycles, motor vehicles,
all-terrain vehicles, snowmobiles, and other non-specified transport.
Source: SMARTRISK. 2009. The Economic Burden of Injury in Canada.48 Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
SMARTRISK was a national charity that focused on injury and fatality prevention. In 2012, SMARTRISK joined with Safe
Communities Canada, Safe Kids Canada, and ThinkFirst Canada to become Parachute, a national charity that acts as a leader in
injury prevention.
g
Based on a cost per weighted case value of $5,390. Calculation of per-day cost is based on annual related costs of $51,263,379.04.
h
These costs include intentional, unintentional, other causes, and undetermined causes of injury-related hospitalizations.
f
20
ORGANIZATION OF THIS
REPORT
This report provides an overview of
the impact of MVCs on the health of
British Columbians and identifies current
successes, challenges, and opportunities
to improve road safety in BC. Chapter2
provides an overview of the burden of
MVCs in BC, including related fatalities
and hospitalizations. Chapters 3to8
look at data and trends related to the
four main pillars of the SSA (safe road
users, safe speeds, safe roadways, and
safe vehicles), examining serious injuries
and fatalities and presenting evidencebased practices from leading jurisdictions
when possible. Chapter9 was developed
in collaboration with the First Nations
Health Authority. It explores MVCs
involving Aboriginal peoples in BC, and
discusses current initiatives and promising
practices to improve road safety in
Aboriginal communities. The final chapter
discusses the main findings presented in
this report, and offers a comprehensive set
of recommendations that aim to prevent
fatalities and serious injuries due to MVCs
in BC. Bolded text throughout this report
indicate glossary terms, which are defined
in AppendixA.
SUMMARY
This chapter has provided an overview of
the data sources and methodologies used in
this report, and outlined key responsibilities
of the various partners and bodies that
together provide governance of road safety
in BC. This report combines population
health and public health perspectives, and a
Safe System Approach (SSA) in its analyses.
It does this by focusing on the impact
of motor vehicle crashes (MVCs) on the
population, and exploring each pillar of the
SSA while examining related fatalities and
serious injuries. Principles of public health
and population health are incorporated
into the analyses, discussions, and related
recommendations in this report. This chapter
showed that Canada ranked somewhat
higher in MVC fatality rates than some other
international jurisdictions and leaders in road
safety. Within Canada, BC ranked fourth
lowest, but slightly higher than the average
for MVC fatality rates, and slightly below the
average for related serious injury rates. Over
time, BC has seen reductions in the number of
MVC-related hospitalizations and fatalities, as
well as in related rates per 100,000 population.
The next chapter will examine the burden of
MVCs in BC in more detail.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
21
22
Chapter 2
Figure
2.1
3.5
25
20
2.5
15
2.0
1.5
10
1.0
5
3.0
0.5
0
Active Licensed
Drivers (Millions)
MVC Fatality Rate
MVC Fatalities
1994
2.41
1995
2.46
1996
2.54
1997
2.59
1998
2.69
1999
2.73
2000
2.75
2001
2.77
2002
2.80
2003
2.84
2004
2.86
2005
2.91
2006
2.96
2007
3.01
2008
3.06
2009
3.11
2010
3.14
2011
3.18
2012
3.21
2013
3.26
20.6
496
19.0
468
17.4
442
16.3
423
15.9
427
14.2
389
14.4
396
13.7
380
16.2
453
15.8
447
15.3
438
16.0
466
13.8
408
14.0
420
11.6
355
11.7
365
11.1
349
8.8
279
8.7
279
7.0
228
Year
Notes: An "active licensed driver" is one who holds a valid BC driver's licence (including a Learner or Novice licence). To be valid, the licence must not be suspended, cancelled, or expired on the date of interest.
The definition of active drivers used was similar to the one used in numbers after 2002 in the ICBC Business Data Warehouse. This chart provides a crude ratio of motor vehicle-related deaths to the number of
active licensed drivers in order to reveal a general trend over time. The ICBC numbers change, especially for the most recent time periods, because of late reporting, corrections, and adjustments.
Sources: Fatality data are from the BC Vital Statistics Agency; driver's licence data are from the Insurance Corporation of BC (ICBC) (data for 1994 to 2002 are from the ICBC mainframe); population estimates are
from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
23
Figure
Population Count and Motor Vehicle Crash Fatality Rate per 100,000 Population
with Key Dates of Road Safety Initiatives, BC, 1986 to 2013
2.2
Prior to 1986
Population (Millions)
24
1965
1977
1971
1985
25
4.0
20
3.0
15
2.0
10
1.0
13
12
20
11
20
1997
20
10
09
20
08
1996
20
07
20
05
06
1995
20
20
04
1994
20
03
1993
20
02
20
01
1992
20
00
99
1991
20
20
98
97
1990
19
19
96
1989
19
95
19
94
1988
19
93
19
92
1987
19
91
90
1986
BC Population
19
19
88
89
19
19
19
19
19
87
86
1998
1999
18.4
19.2
18.1
17.0
18.3
15.3
12.8
13.5
13.5
12.4
11.4
10.7
10.7
9.7
MVC Fatalities
552
584
564
545
604
515
443
482
496
468
442
423
427
389
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
BC Population
4,039,230 4,076,881 4,100,161 4,123,937 4,155,017 4,195,764 4,241,691 4,290,988 4,349,412 4,410,679 4,465,924 4,499,139 4,542,508 4,582,625
9.8
9.3
11.0
10.8
10.5
11.1
9.6
9.8
8.2
8.3
7.8
6.2
6.1
5.0
MVC Fatalities
396
380
453
447
438
466
408
420
355
365
349
279
279
228
Note: See Appendix B for more information about these data sources.
Sources: Fatality data are from the BC Vital Statistics Agency; population estimates are from the BC Stats website, April 2015. Prepared by Population Health Surveillance, Engagement and
Operations, Ministry of Health, 2015.
Event Key
1965 Mandatory motorcycle helmet law
24
x
$
24
5.0
Integrated Road Safety Units (IRSUs) are distinct from the Ministry of Justices Road Safety Unit (RSU). The RSU is a policy unit
within the provincial governments Police Services Division, while IRSUs are teams of officers from independent municipal police
departments and RCMP traffic services who work together to target high-risk driving behaviours.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
25
Figure
2.3a
Northern
6.3%
13.5%
Interior
15.9%
38.8%
Fraser
Vancouver Coastal
Island
16.6%
13.5%
Health Authority
24.7%
Population
12.5%
Number
of MVC
Fatalities
36.6%
21.7%
Percentage
of BC
Population
Percentage
of MVC
Fatalities
13.5
Northern
284,552
38
6.3
Interior
722,357
109
15.9
38.8
1,121,688
35
24.7
12.5
Vancouver Coastal
Island
751,809
38
16.6
13.5
Fraser
1,662,102
61
36.6
21.7
Total
4,542,508
281
Notes: Regional information presented is based on crash location. Percentages are calculated based on population of health authority area. There were five cases in which health authority was unspecified, and these cases are excluded from this
figure. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2012; population data are from BC Statistics, Population Estimates, 2012. Prepared by BC Injury
Research and Prevention Unit, 2014.
26
Analysis by Region
BC is divided into five geographic regional
health authority areas for health service
delivery. Figure 2.3a shows that more than
half of the approximately 4.5 million people
in BC are concentrated within two of the
geographically smallest health authority
areas: Fraser Health and Vancouver Coastal
Health. In contrast, Northern Health is
the most rural and remote health authority,
encompassing almost two-thirds of the
province geographically, while home to
only a small percentage of the total BC
Figure
2.3b
Population
MVC Fatalities
6.3%
36.6%
21.7%
15.9%
24.7%
13.5%
38.8%
12.5%
16.6%
Northern
13.5%
Interior
Vancouver Coastal
Island
Fraser
Notes: Regional information presented is based on crash location. Percentages are calculated based on population of health authority area. There were five
cases in which health authority was unspecified, and these cases are excluded from this figure. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2012;
population data are from BC Statistics, Population Estimates, 2012. Prepared by BC Injury Research and Prevention Unit, 2014.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
27
Figure
Figure 2.4 shows the average agestandardized MVC fatality rates (20082012)
per 100,000 population by health authority.
The highest rates in BC occurred in
Northern Health and Interior Health,
at 18.0and 16.3 fatalities per 100,000,
respectively. These rates are higher than the
BC average rate of 6.9 per 100,000 for this
time period, and considerably higher than
rates for other regions (three to nearly eight
times higher). The lowest MVC fatality rate
is found in Vancouver Coastal Health, at
2.3fatalities per 100,000.
2.4
22
20
18
16
14
12
Average (6.9)
10
8
6
4
2
0
Northern
Interior
Island
Fraser
Vancouver Coastal
18.0
16.3
6.0
4.8
2.3
Health Authority
Notes: Health authority rates are based on the residence of the patient and may not be the same as the location of the crash or the location of the health
care service provided. Rates are calculated based on the population of the health authority. Age-standardized rates are calculated using Canada 1991
Census population. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
2008-2012; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
28
Figure
2.5
160
140
120
Average (85.0)
100
80
60
40
20
0
Northern
Interior
Island
Fraser
Vancouver Coastal
134.9
124.5
85.0
78.1
54.1
Health Authority
Notes: Health authority rates are based on the residence of the patient and may not be the same as the location of the crash or the location of the health
care service provided. Rates are calculated based on the population of the health authority. Age-standardized rates are calculated using Canada 1991
Census population. There were fewer than five cases in which health authority was unspecified, and these cases are excluded from this figure. See Appendix
B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2006-2010; population estimates are from the BC Stats website,
April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
A high volume of commercial vehicle traffic or frequent use by large and heavy vehicles requires specific road design and
maintenance to ensure the integrity and ongoing safety of roadways.
j
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
29
Analysis by Sex
Figure
2.6
200
180
Number of Fatalities
160
140
120
100
80
60
40
20
0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Interior
130
179
152
141
146
145
135
115
145
122
113
109
Fraser
115
106
125
112
125
90
109
105
84
102
62
61
Vancouver Coastal
50
57
49
58
57
59
51
30
30
23
25
35
Northern
58
78
60
71
64
57
53
52
48
61
57
38
Island
41
37
62
55
61
51
61
52
56
56
35
38
BC Total
394
457
448
440
453
402
411
354
363
364
292
281
Year
Notes: Health authority is presented based on crash location. Rates are calculated based on population of health authority. There were five cases in which
health authority was unspecified, and these cases are excluded from this figure. See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2001-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
30
Figure
2.7
18
16
14
12
10
8
6
4
2
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Male
16.7
15.7
14.9
13.8
13.1
13.3
16.0
14.7
14.8
14.4
13.3
12.4
10.5
11.0
10.1
8.2
7.7
7.0
Female
7.4
5.7
6.3
6.3
6.1
5.6
5.7
6.1
5.8
6.4
4.7
5.4
4.9
4.3
5.0
3.7
3.7
3.7
BC
12.0
10.7
10.6
10.0
9.6
9.4
10.8
10.4
10.3
10.4
9.0
8.9
7.7
7.6
7.5
5.9
5.7
5.4
Year
Notes: There were 101 cases where age group was missing, and these cases are excluded from this figure. There were 24 cases where sex was missing, but
these cases are included in the total rate. Age-standardized rates are calculated using Canada 1991 Census population. See Appendix B for more information
about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 1996-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
31
Figure
2.8
100
90
80
70
60
50
40
30
20
10
0
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Male
92.9
92.2
91.5
88.1
82.4
81.6
78.5
70.0
65.9
56.9
Female
55.3
59.6
54.4
51.4
55.8
50.6
46.8
43.4
41.2
39.0
BC
73.6
75.4
72.6
69.3
68.9
66.0
62.3
56.4
53.4
47.8
Year
Notes: Age-standardized rates are calculated using Canada 1991 Census population. See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats website, April
2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
32
Analysis by Age
Trend analyses suggest that in addition
to region and sex, age also plays a role in
the burden of MVC fatalities and injuries.
Figure2.9 shows that from 2002 to 2013,
there were considerable successes in reducing
MVC fatality rates per 100,000 population.
The highest fatality rates seen here areamong
those age 16-25, and 76 and up. The
1625age group achieved the greatest decrease
in fatality rate overall during this period
(60.3per cent). The rate jumped from 2008
to 2009 among those age 76 and up, and the
highest MVC fatality rate was experienced by
this age group from 2009 onward.
Figure 2.10 shows that from 2002 to 2011,
there were similar trends for hospitalization
rates as for fatality rates among the age
groups, with those age 16-25 and 76 and
up having the highest rates per 100,000
population among the age groups. However,
Figure
2.9
Fatality Rate
per 100,000 Population
25
20
15
10
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
0-15
2.9
3.7
2.0
1.3
1.9
1.5
1.6
1.2
2.4
1.2
1.8
1.0
16-25
20.4
21.5
16.7
23.0
17.0
17.4
14.7
11.9
9.9
10.1
8.5
8.1
26-35
11.6
9.4
13.0
13.0
10.9
9.2
8.2
7.6
8.9
6.4
6.0
7.2
36-45
10.2
10.3
9.5
7.9
9.3
10.5
8.3
10.0
7.6
5.0
6.3
4.5
46-55
8.8
8.2
9.8
9.1
8.0
10.2
7.0
9.9
10.2
6.4
5.7
5.2
56-65
13.1
8.0
12.3
9.7
8.6
7.3
9.1
6.8
7.6
7.5
5.3
6.2
66-75
12.2
11.8
12.6
8.8
6.6
7.4
6.6
6.1
7.9
6.2
7.3
7.4
76+
18.7
21.1
17.3
20.1
17.2
13.7
11.9
17.8
13.9
12.9
12.5
11.2
Year
Notes: There were 63 cases where age group was missing, and these cases are excluded from this figure. See Appendix B for more information about these
data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2002-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Figure
2.10
200
Hospitalization Rate
per 100,000 Population
180
160
140
120
100
80
60
40
20
0
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0-15
41.3
36.6
38.7
34.2
33.9
30.1
24.6
19.3
22.4
16.7
16-25
171.9
167.8
161.8
157.2
154.2
140.6
128.8
112.7
101.5
91.4
26-35
112.2
108.7
112.8
111.4
102.4
108.0
105.3
87.6
80.1
69.5
36-45
89.6
91.2
93.6
92.3
92.0
88.6
89.6
78.3
75.7
67.2
46-55
87.6
92.5
86.5
86.6
84.0
84.9
81.8
90.0
77.4
72.9
56-65
79.7
75.3
73.3
77.2
91.2
82.4
73.9
78.1
78.3
72.2
66-75
100.7
85.1
98.9
84.2
92.9
80.9
80.5
81.5
76.0
74.2
76+
129.3
149.3
133.4
125.2
131.1
128.9
128.7
115.3
118.4
114.4
Year
Notes: Rates are calculated using age-specific population. See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats website,
April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
33
A U-shaped curve is often observed when agespecific MVC risks are charted: fatality and
hospitalization rates are high for younger road
users, decrease for those in middle age groups,
and increase again for older road users.9
Figures 2.11 and 2.12 reflect this U-shape,
though it is most pronounced for males. These
figures also demonstrate that the increase
in risk of suffering a fatality or of sustaining
a serious injury due to an MVC increases
dramatically at age 16. Since individuals can
only drive once they are 16years old, this
suggests that when youth begin to drive they
are at much higher risk of being killed or
seriously injured in an MVCfor both males
and females, but particularly for young males.
(See Chapter 5 for additional discussions of
driver behaviour).
Figure
2.11
20
18
16
14
12
10
8
6
4
2
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
1.6
13.0
10.3
9.2
10.6
9.5
8.7
19.6
Female
1.4
6.1
4.1
4.2
4.4
3.8
5.4
9.2
Age Group
Notes: Rates are calculated using age- and sex-specific population numbers. There were 19 cases where age group and/or sex was missing, and these cases
are excluded from this figure. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
34
Figure
2.12
Hospitalization Rate per 100,000 Population
160
140
120
100
80
60
40
20
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
27.5
151.3
125.1
115.0
112.0
106.7
79.3
124.1
Female
17.4
76.6
54.4
45.6
51.3
47.2
77.6
118.7
Age Group
Notes: Rates are calculated using age- and sex-specific population numbers. See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2007-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry
of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
35
36
Road condition includes considerations such as ice, snow, slush, and water, while weather includes fog, sleet, rain, and snow.
2.13
40
Percentage of Fatalities
35
30
25
20
15
10
5
0
2008
2009
2010
2011
2012
Speed
37.6
36.6
31.0
33.6
35.7
Impairment
31.6
29.2
34.9
25.7
20.4
Distraction
25.7
27.3
28.0
27.1
28.6
Driver Error/Confusion
15.8
9.9
8.0
5.8
4.6
13.6
10.7
15.7
8.6
6.8
Road Condition
13.6
12.4
10.7
13.7
17.1
Year
Notes: "Impairment" includes alcohol involvement, ability impaired by alcohol, alcohol suspected, drugs illegal, ability impaired by drugs, drugs suspected,
and ability impaired by medication. "Distraction" includes use of communication/video equipment, driver inattention, and driver internal/external
distraction. "Driver error/confusion" includes gas/brake pedal confusion. "Road condition" includes ice, snow, slush, and/or water on the road. Data are
based on police reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other
systemic factors (e.g., vehicle design, roadway design). See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
37
Figure
2.14
Northern
Pop
6.3%
18.0%
21.0%
13.0%
Interior
Pop
16.0%
Pop
42.5%
37.9%
39.4%
Population
Speed
Impairment
Distraction
Fraser
Vancouver Coastal
Island
Pop
Pop
Pop
16.6%
13.2%
Health Authority
Northern
Interior
Vancouver Coastal
Island
Fraser
BC Total
24.7%
13.1% 13.3%
Population
282,826
721,190
1,110,349
748,797
1,637,014
4,500,175
7.3%
Percentage of
BC
Population
Number of
Speed-related
Fatalities
6.3%
16.0%
24.7%
16.6%
36.4%
94
222
38
69
99
522
6.1%
8.0%
Percentage Number of
of Speed- Impairmentrelated
related
Fatalities
Fatalities
18.0%
42.5%
7.3%
13.2%
19.0%
90
162
26
56
94
428
36.4%
19.0%
22.0%
26.3%
Percentage of
Impairmentrelated
Fatalities
Number of
Distractionrelated
Fatalities
Percentage of
Distractionrelated
Fatalities
21.0%
37.9%
6.1%
13.1%
22.0%
57
172
35
58
115
437
13.0%
39.4%
8.0%
13.3%
26.3%
Notes: Regional information presented is based on crash location. "Population" is the average population for 2009 to 2013. Population percentage is calculated based on the population of health authority area. There were cases in
which health authority was unspecified, and these cases are excluded from this figure. "Speed-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: unsafe speed,
exceeding speed limit, excessive speed over 40 km/h, and/or driving too fast for conditions. "Distraction-related" fatalities are deaths where one or more vehicles involved in the crash had any one of the contributing factors: use of
communication/video equipment, driver internal/external distraction, and/or driver inattention. "Impaired-related" fatalities are deaths where one or more vehicles involved in the crash had any one of the contributing factors of:
alcohol involvement, prescribed medication and/or drug involvement listed. Data are based on police reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than
other systemic factors (e.g., vehicle design, roadway design). Victim may or may not be the impaired person involved in the crash. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia 2009-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury
Research and Prevention Unit, 2015; and the Office of the Provincial Health Officer, 2015.
38
Figure
2.15
Percentage of Fatalities
50
45
40
35
30
25
20
15
10
5
0
Male
Female
Speed
37.0
30.6
Impairment
32.5
21.3
Distraction
25.6
30.9
8.5
10.4
10.8
12.5
Road Condition
11.8
16.7
Driver Error/Confusion
Sex
Notes: "Impairment" includes alcohol involvement, ability impaired by alcohol, alcohol suspected, drugs illegal, ability impaired by drugs, drugs suspected,
and ability impaired by medication. "Distraction" includes use of communication/video equipment, driver inattentive, and driver internal/external distraction.
"Driver error/confusion" includes gas/brake pedal confusion. "Road condition" includes ice, snow, slush, and/or water on the road. Data are based on police
reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g.,
vehicle design, roadway design). Fewer than five cases had sex data missing, and these cases are excluded from this figure. See Appendix B for more
information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
39
SUMMARY
Over the last few decades there has been
an increase in road users in BC, based on
increases in the size of the BC population
and in the number of active drivers licences.
Figure
2.16
Percentage of Fatalities
60
50
40
30
20
10
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Speed
31.1
55.2
41.4
38.6
32.1
27.9
19.7
10.8
Impairment
18.0
46.9
44.1
31.8
25.2
21.6
5.1
7.2
Distraction
21.3
22.4
19.8
25.0
32.1
30.9
28.2
38.1
Driver Error/Confusion
9.8
5.2
7.2
7.6
11.3
10.8
9.4
14.9
18.0
13.2
12.6
9.7
12.0
8.8
7.7
10.3
Road Condition
24.6
11.7
8.6
16.1
15.3
17.2
16.2
5.7
Age Group
Notes: "Impairment" includes alcohol involvement, ability impaired by alcohol, alcohol suspected, drugs illegal, ability impaired by drugs, drugs suspected,
and ability impaired by medication. "Distraction" includes use of communication/video equipment, driver inattentive, and driver internal/external distraction.
"Driver error/confusion" includes gas/brake pedal confusion. "Road condition" includes ice, snow, slush, and/or water on the road. Data are based on police
reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g.,
vehicle design, roadway design). There were 19 cases in which age group was unknown, and these cases are excluded from this figure. See Appendix B for
more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
40
Chapter 3
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
41
Figure
3.1
46.1%
Passenger Vehicle
Passenger
20.5%
11.0%
Motorcycle Occupant
18.5%
Other
0.8%
3.0%
Cyclist
Pedestrian
Notes: "Passenger vehicle" includes cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle
occupant" includes motorcycle drivers and passengers. See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
42
Figure
3.2
Motorcycle Occupant
20.6%
Passenger Vehicle
Occupant
54.4%
6.4%
Cyclist
15.0%
Pedestrian
3.7%
Other
Notes: "Passenger vehicle occupant" includes drivers and passengers of cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and
excludes motorcycle occupants. "Motorcycle occupant" includes motorcycle drivers and passengers. See Appendix B for more information about this
data source.
Source: Discharge Abstract Database, Ministry of Health, 2007-2011. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Figure
3.3
4.5
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2010
2011
2012
2013
4.0
3.9
2.8
2.7
2.7
2009
1.5
2.0
1.4
1.3
1.0
Motorcycle Occupant
1.1
0.8
0.8
0.5
0.6
Cyclist
0.2
0.1
0.2
0.2
0.3
Pedestrian
1.3
1.3
1.3
1.4
1.1
Other
0.1
0.0
0.0
0.0
0.1
Year
Notes: "Passenger vehicle" includes cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle
occupant" includes motorcycle drivers and passengers. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
2009-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
43
Figure
3.4
80
Hospitalization Rate
per 100,000 Population
70
60
50
40
30
20
10
0
2007
2008
2009
2010
2011
72.0
68.3
64.4
60.6
54.5
Motorcycle Occupant
15.9
17.0
16.8
16.5
14.6
Cyclist
5.0
4.8
4.8
5.1
5.3
Pedestrian
13.4
12.6
11.0
11.0
11.0
Other
3.2
3.6
3.2
2.5
2.0
Year
Notes: "Passenger vehicle" includes cars, trucks, sport utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle
occupant" includes motorcycle drivers and passengers. "Other" includes animal-drawn vehicles driven on roads governed by the Motor Vehicle Act. See
Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2007-2011; population estimates are from the BC Stats website,
April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
44
Figure
3.5
Passenger Vehicle
Passenger
Passenger Vehicle
Driver
13.3%
22.6%
Motorcycle Occupant
14.9%
0.5%
Other
4.6%
Cyclist
44.1%
Pedestrian
Notes: "Passenger vehicle" includes cars, trucks, sport utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle
occupants" includes motorcycle drivers and passengers. Greater Vancouver excludes the Fraser Valley region. See Appendix B for more information
about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Some of these reports are accessible via the website of the Office of the Provincial Health Officer (www.health.gov.bc.ca/pho/reports).
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
45
Figure
Number of Fatalities
3.6
400
350
300
250
4
200
3
150
2
100
50
0
2013
217
211
201
203
197
204
244
185
177
124
145
133
116
102
106
101
132
362
344
317
305
303
305
376
5.6
5.3
5.0
5.1
4.9
5.0
3.7
3.4
2.9
2.5
2.6
2.5
222
224
193
197
178
175
125
121
140
90
102
92
83
70
67
88
63
58
46
325
312
326
285
280
247
245
263
188
179
170
6.0
4.5
5.3
5.3
4.6
4.6
4.1
4.0
3.9
2.8
2.7
2.7
3.2
3.4
2.2
2.4
2.2
1.9
1.6
1.5
2.0
1.4
1.3
1.0
Year
Notes: "Drivers" and "passengers" include drivers and passengers of cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and exclude
motorcycle occupants. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 1996-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
46
Figure
3.7
70
3,000
60
Number of Hospitalizations
2,500
50
2,000
40
1,500
30
1,000
20
500
10
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Number of Hospitalizations
2,442
2,489
2,470
2,326
2,294
2,195
2,018
1,890
1,740
1,558
Hospitalization Rate
59.6
60.4
59.4
55.4
54.1
51.2
46.4
42.9
39.0
34.6
Year
Notes: "Drivers" and "passengers" include drivers and passengers of cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and exclude
motorcycle occupants. See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats website,
April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health,
Figure
3.8
12
10
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
8.5
6.1
5.6
6.7
4.9
4.1
12.8
Female
3.9
2.2
2.1
1.8
1.2
1.8
5.3
Age Group
Notes: "Driver" includes drivers of cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycle occupants.
Five-year average rates are calculated using age- and sex-specific driver population numbers (Sept. 2014), based on active BC driver's licences. Not
all individuals who hold driver's licences own or operate vehicles in BC. There were fewer than five cases where the driver was under 16 years old,
and these cases are excluded from this figure. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia
(ICBC), 2009-2013; driver population data are from the Business Information Warehouse, ICBC, as of September 30, 2014.
Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
47
Figure
3.9
Fatality Rate per 100,000 Population
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.6
3.4
1.3
1.2
0.8
0.8
1.0
2.0
Female
1.0
2.0
1.2
1.6
1.2
1.1
1.2
3.5
Age Group
Notes: "Passenger" includes passengers of cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycle
occupants. Rates are calculated using age- and sex-specific population numbers. There were six cases where age group was missing, and these cases
are excluded from this figure. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
2009-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
48
Figure
3.10
Hospitalization Rate per 100,000 Population
(with 95% CI)
100
90
80
70
60
50
40
30
20
10
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
7.3
78.7
59.7
49.5
47.0
41.2
46.3
84.1
Female
8.4
54.1
35.8
29.9
31.1
37.4
56.1
90.7
Age Group
Notes: "Motor vehicle occupant" includes drivers and passengers of cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and
excludes motorcycle occupants. Rates are calculated using age- and sex-specific population numbers. See Appendix B for more information about
these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2007-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations,
Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
49
Figure
3.11
Population
66-75
7.9%
76+
6.4%
56 - 65
13.0%
46-55
15.6%
MVC Fatalities
76+
12.6%
0-15
16.4%
16-25
13.3%
26-35
13.5%
36-45
13.9%
66-75
8.1%
0-15
3.6%
16-25
18.6%
56-65
12.5%
26-35
14.2%
46-55
16.9%
36-45
13.5%
Notes: "Fatalities" include deaths resulting from motor vehicle crashes involving all types of vehicles, including motorcycles. There were 16 cases where
age group was missing, and these cases are excluded from this figure. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
50
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
51
3.12
Crash Rate per 100,000 Licenced
Heavy Commercial Vehicles
25,000
20,000
15,000
10,000
5,000
Crash Rate
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
21,900
21,900
22,340
22,560
22,750
21,610
19,670
18,130
18,720
18,660
18,460
Year
Notes: "Heavy commercial vehicles" for this figure include commercial vehicles greater than or equal to 11,795 kg. Rates are calculated using the total
number of licenced vehicles, based on Insurance Corporation of British Columbia records as a proxy denominator.
Source: Adapted from British Columbia Trucking Association. 2015. Collisions Involving Heavy Commercial Vehicles.25 Prepared by BC Injury Research and
Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
52
3.13
500
Number of Fatalities
450
2.5
400
350
2.0
300
250
1.5
200
1.0
150
100
0.5
50
0
Number of MVC Fatalities
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
469
429
429
409
396
394
457
448
440
452
402
411
354
363
364
292
280
269
69
85
72
92
85
68
100
83
88
86
79
72
63
73
59
71
67
50
Commercial Vehicle
MVC Fatality Rate
1.8
2.2
1.8
2.3
2.1
1.7
2.4
2.0
2.1
2.0
1.9
1.7
1.4
1.7
1.3
1.6
1.5
1.1
14.7
19.8
16.8
22.5
21.5
17.3
21.9
18.5
20.0
19.0
19.7
17.5
17.8
20.1
16.2
24.3
23.9
18.6
Figure
0.0
Year
Notes: "Commerical vehicle" includes heavy vehicles, such as trucks, trailers, tractors, buses, and construction vehicles. See Appendix B for more
information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and
Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
53
Figure
3.14
Passenger Vehicle
Passenger
Passenger Vehicle
Driver
21.9%
54.7%
5.6%
3.8%
Motorcycle Occupant
13.8%
Cyclist
Other
0.3%
Pedestrian
Notes: "Commerical vehicle" includes heavy vehicles, such as trucks, trailers, tractors, buses, and construction vehicles. "Passenger vehicle" includes cars,
trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle occupant" includes motorcycle drivers and passengers.
See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
54
Figure
3.15
Fatality Rate per 100,000 Population
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.3
2.0
2.4
1.7
3.0
2.2
1.7
2.5
Female
0.5
0.8
0.6
1.0
0.9
1.0
1.1
1.6
Age Group
Notes: "Commercial vehicle" includes heavy vehicles, such as trucks, trailers, tractors, buses, and construction vehicles. Rates are calculated using age- and
sex-specific population numbers. There were seven cases where age group and/or sex was missing, and these cases are excluded from this figure. See
Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
2009-2013; population data are from BC Vital Statistics, 2009-2013. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
WorkSafe BCs MVC-related claims data do not reflect every worker-involved MVC in BC, as some workers are involved in MVCs
with third-party liability, or choose to report the incident to ICBC rather than to WorkSafe BC.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
55
56
Table
3.1
Motor Vehicle Crash Patient Count, Proportion and Mean Hospital Stay,
by Restraint Use and Urban or Rural Location, BC, 2001-2008
URBAN
RESTRAINT USE
RURAL
ALL
Patient Count Mean Hospital Patient Count Mean Hospital Patient Count Mean Hospital
(per cent)
Stay (days)
(per cent)
Stay (days)
(per cent)
Stay (days)
Restrained
1,641
(74%)
14.2
535
(61%)
13.4
2,176
(70%)
14.0
Unrestrained
583
(26%)
14.2
337
(39%)
16.6
920
(30%)
15.2
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
57
3.16
10
9
Percentage of Non-use
8
7
6
5
4
3
2
1
0
Rural
BC
Canada
8.4
8.0
Urban
2.7
Overall
3.1
4.2
4.7
Region
Note: See Appendix B for more information about this data source.
Source: Transport Canada. 2011. Rural and Urban Surveys of Seat Belt Use in Canada 2009-2010.42 Prepared by Population Health Surveillance,
Engagement and Operations, Ministry of Health, 2015.
58
Typically nine or more penalty points within a two-year period, or two points for drivers in the BC GLP.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
59
60
Road Safety at Work was formerly known as the Occupational Road Safety Partnership.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
61
SUMMARY
As discussed in this chapter, vehicle
occupants (drivers and passengers) make
up the majority of motor vehicle crash
(MVC) fatalities and hospitalizations,
although these rates have been decreasing
in recent years. Male drivers have higher
MVC fatality rates than female drivers at
every age, while females are more likely
than males to die as passengers at most
ages. Overall, youth age 16-25 and older
adults age 76 and up are disproportionately
represented among MVC occupant fatality
victims. Over the last 18 years, there has
been a slight decrease in the rate of MVC
fatalities that involve a commercial vehicle;
however, in 2013 nearly one in five MVC
fatalities still involved a heavy commercial
vehicle. Measures to promote driver and
passenger safety discussed in this chapter
included increasing the use of restraints,
supporting expanded drivers licence
programs, increasing initiatives to prevent
commercial vehicle MVCs, and increasing
opportunities for public transportation.
The next chapter will investigate motor
vehicle crashes that involve vulnerable road
users in BC.
62
Chapter 4
No longer is it acceptable to assume pedestrian injury is inevitable when motor vehicles share the
road system with vulnerable road users. In the modern era of road safety, jurisdictions can assume
a safe system approach and include pedestrians and other vulnerable road users as an essential
component of the system and one that is given top priority.
Canadian Council of Motor Transport Administrators, Countermeasures to Improve Pedestrian Safety
in Canada 4(p.5)
Some definitions of vulnerable road user exclude motorcyclists. They are included in this category in this report because they
lack the protection or enclosure of a vehicle, and because their smaller size reduces their visibility to other motor vehicle drivers.
q
In this report cyclist refers to a person riding a bicycle, as well as riders or passengers of other pedal-powered vehicles,
including childrens or adult tricycles, tandem bicycles, and other configurations of pedal cycles.
p
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
63
4.1
40
35
30
25
20
15
10
5
0
2009
2010
2011
2012
2013
12.9
9.9
13.0
8.6
10.8
2.8
1.6
2.4
3.9
4.8
Pedestrian
16.0
15.9
19.5
23.2
19.3
31.7
27.5
34.9
35.7
34.9
115
100
102
100
94
Motorcycle Occupant
Cyclist
Year
Notes: "Vulnerable road users" are those who use the road without the protection of an enclosed vehicle. "Motorcycle occupant" includes motorcycle
drivers and passengers. See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
64
Figure
4.2
50
45
40
35
30
25
20
15
10
5
0
Motorcycle Occupant
Cyclist
Pedestrian
Total Percentage among MVC Hospitalizations
Number of Vulnerable Road User Hospitalizations
2007
2008
2009
2010
2011
18.0
20.2
21.3
22.3
21.7
5.6
5.7
6.1
6.9
7.8
15.2
14.9
14.0
14.9
16.2
38.7
40.8
41.4
44.1
45.7
1,473
1,498
1,435
1,460
1,388
Year
Notes: "Vulnerable road users" are those who use the road without the protection of an enclosed vehicle. "Motorcycle occupant" includes motorcycle drivers
and passengers. See Appendix B for more information about this data source.
Source: Discharge Abstract Database, Ministry of Health, 2007-2011. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
65
Figure
4.3
Northern
Pop
6.3%
12.1%
2.1%
5.9%
Interior
Pop
16.0% 35.1% 25.5% 21.0%
Pop Population
Motorcycle
Cyclist
Pedestrian
Fraser
Vancouver Coastal
Island
Pop
Pop
Pop
24.7% 11.5% 10.6% 23.8%
Health Authority
Northern
Interior
Vancouver Coastal
Island
Fraser
BC Total
Population
282,826
721,190
1,110,349
748,797
1,637,014
4,500,175
Percentage of
BC Population
6.3%
16.0%
24.7%
16.6%
36.4%
Number of
Motorcyclist
Fatalities
21
61
20
34
38
174
Percentage of
Motorcyclist
Fatalities
12.1%
35.1%
11.5%
19.5%
21.8%
Number of
Percentage of
Number of
Pedestrian
Fatalities
17
61
69
48
95
290
Percentage of
Pedestrian
Fatalities
5.9%
21.0%
23.8%
16.6%
32.8%
Notes: Regional information presented is based on crash location. "Population" is the average population for 2009-2013. Population percentage is calculated based on the population of the health authority area. There were cases in
which health authority was unspecified, and these cases are excluded from this figure. "Motorcycle occupant" includes motorcycle drivers and passengers. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia 2009-2013; population estimates are from the BC Stats website, April 2015. Prepared by
BC Injury Research and Prevention Unit, 2015; and the Office of the Provincial Health Officer, 2015.
66
Number of
Pedestrian
Fatalities
61
95
69
48
17
290
MOTORCYCLISTS
Fatalities and Serious Injuries
among Motorcyclists
According to the Insurance Corporation
of British Columbia (ICBC), motorcycles
represent approximately 3 per cent of
insured vehicles in BC, yet are involved
in about 11 per cent of MVC fatalities.14
Motorcyclists lack the protection and
safety features of an enclosed vehicle but
are travelling at high speeds with other
vehicles, a dangerous combination that can
create an increased risk of serious injury
and death. ICBC reports that in 2013 there
were 2,200 MVCs that involved at least one
motorcycle in BC. These MVCs resulted in
approximately 1,500 injured victims and
29 fatalities.15 Research in the United States
has found that per vehicle mile travelled,
motorcyclists have a 34-fold higher risk of
death in an MVC than people driving other
types of vehicles.16 Another US study found
that while 20 per cent of passenger vehicle
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
67
Figure
50
45
1.0
Number of Fatalities
40
35
0.8
30
0.6
25
20
0.4
15
10
0.2
5
0
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Number of Fatalities
23
22
25
25
29
28
32
33
44
47
40
48
39
47
36
38
24
29
Fatality Rate
0.59
0.56
0.63
0.62
0.72
0.69
0.78
0.80
1.06
1.12
0.94
1.12
0.90
1.07
0.81
0.84
0.53
0.63
0.0
Year
Notes: "Motorcycle occupant" includes motorcycle drivers and passengers. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
68
4.4
Figure
4.5
800
20
18
700
14
500
12
400
10
8
300
Hospitalization Rate
per 100,000 Population
Number of Hospitalizations
16
600
200
4
100
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Number of Hospitalizations
613
598
643
688
741
683
741
739
739
658
Hospitalization Rate
15.0
14.5
15.5
16.4
17.5
15.9
17.0
16.8
16.5
14.6
Year
Notes: "Motorcycle Occupant" includes motorcycle drivers and passengers. See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations,
Ministry of Health, 2015.
Figure
4.6
Fatality Rate per 100,000 Population
2.25
2.00
1.75
1.50
1.25
1.00
0.75
0.50
0.25
0.00
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.11
1.76
1.65
2.00
1.90
2.06
1.26
0.00
Female
0.00
0.07
0.00
0.13
0.51
0.21
0.00
0.00
BC
0.05
0.94
0.82
1.05
1.19
1.13
0.62
0.00
Age Group
Notes: "Motorcycle occupant" includes motorcycle drivers and passengers. Data should be interpreted with caution due to small numbers. Rates are
calculated using age- and sex-specific population numbers. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
2009-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
69
Figure
4.7
45
40
35
30
25
20
15
10
5
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
Male
7.0
35.8
38.8
39.6
38.4
30.9
11.3
76+
8.5
Female
0.8
4.9
5.1
5.4
7.5
4.7
1.3
1.9
BC
4.0
20.7
21.9
22.3
22.8
17.8
6.2
4.7
Age Group
Notes: "Motorcycle occupant" includes motorcycle drivers and passengers. Rates are calculated using age- and sex-specific population numbers. See
Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2007-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations,
Ministry of Health, 2015.
70
71
CYCLISTS
14
Number of Fatalities
12
0.25
10
0.20
8
0.15
6
0.10
4
0.05
0
Number of Fatalities
Fatality Rate
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
6
10
0.15
0.20
0.25
0.22
*
*
*
*
12
10
10
11
13
0.15
0.15
0.19
0.17
0.28
0.23
0.21
0.23
0.13
0.16
0.24
0.28
4.8
0.00
Year
Notes: "*" Indicates numbers less than five, and their associated rates. Data should be interpreted with caution due to small numbers. See Appendix B for
more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 1996-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Note that the figures 1,500 and 1,300 reflect ICBC data rounded to the nearest 100. ICBC data differ from police-reported data, as
police do not attend all MVCs, and not all MVCs are reported to police.
r
72
Figure
5.4
Number of Hospitalizations
250
5.2
200
5.0
150
4.8
100
4.6
50
4.4
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Number of Hospitalizations
191
200
192
208
205
213
210
210
229
237
Hospitalization Rate
4.7
4.8
4.6
5.0
4.8
5.0
4.8
4.8
5.1
5.3
4.9
4.2
Year
Note: See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats website,
April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
73
Figure 4.11 examines the 1,099 hospitalizations of cyclists in the most recent five
years for which there are data available. It
depicts the rate of cyclist-involved MVC
serious injuries for 2007-2011, by sex
and age group. Males had higher rates of
hospitalizations compared to females in all
categories. The highest rates among males
were between 16 and 55 years of age. Females
had much lower and more variable rates,
with the highest rate being among those
age 26-35 (4.0 serious injuries per 100,000
population). As noted with the fatality data,
this information should be interpreted with
caution since the total number of cyclists and
their age and sex are not known.
Figure
4.10
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.26
0.07
0.40
0.45
0.46
0.34
0.34
0.65
Female
0.06
0.14
0.07
0.19
0.00
0.07
0.00
0.00
BC
0.16
0.10
0.23
0.32
0.23
0.21
0.17
0.28
Age Group
Notes: Data should be interpreted with caution due to small numbers. Rates are calculated using age- and sex-specific population numbers. See Appendix B
for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
74
Figure
4.11
12
Hospitalization Rate
per 100,000 Population
10
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
4.6
9.6
9.4
10.1
10.3
7.1
4.2
4.3
Female
1.3
2.0
4.0
1.9
2.5
3.1
0.7
0.1
BC
3.0
5.9
6.7
5.9
6.3
5.1
2.4
1.9
Age Group
Notes: Data should be interpreted with caution due to small numbers. Rates are calculated using age- and sex-specific population numbers. See
Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2007-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry
of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
75
4.12
Notes: Photo credit for Protected Cycling Paths and Intersection Prioritizing Cyclists Ken Ohrn. Photo credit for Painted Cycling Lane BC
Ministry of Transportation and Infrastructure. Reproduced with permission.
Sources: Protected Cycling Paths and Intersection Prioritizing Cyclists source Photographer Ken Ohrn. Painted Cycling Lane source BC
Ministry of Transportation and Infrastructure, CC BY-NC-ND 2.0 (see: https://creativecommons.org/licenses/by-nc-nd/2.0/).
76
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
77
PEDESTRIANS
Figure
80
1.8
70
1.6
Number of Fatalities
60
1.4
50
1.2
1.0
40
0.8
30
0.6
20
0.4
10
0.2
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
2013
Number of Fatalities
71
50
65
64
53
54
40
74
74
66
65
72
56
58
58
57
65
52
Fatality Rate
1.8
1.3
1.6
1.6
1.3
1.3
1.0
1.8
1.8
1.6
1.5
1.7
1.3
1.3
1.3
1.3
1.4
1.1
0.0
Year
Note: See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
78
4.13
Figure
4.14
16
600
550
Number of Hospitalizations
14
500
12
450
400
10
350
300
250
6
200
150
100
2
50
0
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Number of Hospitalizations
565
534
539
534
567
577
547
486
492
493
Hospitalization Rate
13.8
12.9
13.0
12.7
13.4
13.4
12.6
11.0
11.0
11.0
Year
Note: See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2002-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of
Health, 2015.
The BC Coroners Service Child Death Review Unit defines children as those under age 19.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
79
80
Figure
4.15
Fatality Rate per 100,000 Population
(with 95% CI)
10
9
8
7
6
5
4
3
2
1
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.5
1.4
1.2
0.6
1.3
1.4
1.6
6.9
Female
0.3
1.1
0.9
0.4
1.1
1.1
2.4
3.1
BC
0.4
1.3
1.0
0.5
1.2
1.2
2.0
4.7
Age Group
Notes: Rates are calculated using age- and sex-specific population numbers. There were nine cases where age group and/or sex was missing, and these
cases are excluded from this figure. Cases with missing sex data have been included in total rates. See Appendix B for more information about these data
sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
81
Figure
4.16
30
25
20
15
10
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
6.8
20.5
11.6
11.1
11.4
11.9
14.8
24.9
Female
6.1
12.7
7.9
6.6
8.9
12.0
18.6
24.5
Age Group
Notes: Rates are calculated using age- and sex-specific population numbers. There were fewer than five cases in which sex was unknown, and these
cases are excluded from this figure. See Appendix B for more information about these data sources.
Sources: Hospitalization data are from the Discharge Abstract Database, Ministry of Health, 2007-2011; population estimates are from the BC Stats
website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations,
Ministry of Health, 2015.
82
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
83
SUMMARY
Promoting the safety of road users
including vulnerable road usersis a critical
component of a safe roadway system.
Unfortunately, there has not been the same
decrease in MVC fatalities for vulnerable
road users compared to vehicle occupants.
The MVC fatality rate for motorcyclists
increased between 1995 and 2005, followed
by notable decreases after 2009. There
has been an increase in MVC fatality and
serious injury rates among cyclists over
the last several years, with men being
disproportionately more affected. Pedestrian
MVC fatalities and serious injuries have
fluctuated over the years but do not show a
clear downward trend. In addition, cyclists
and pedestrians in BC have higher rates
of fatalities and serious injuries compared
to vehicle occupants when measured on a
per trip or kilometres travelled basis. Both
children and older adults are especially
84
Chapter 5
N. Arason, No Accident:
Eliminating Injury and Death on
Canadian Roads 1(p.101)
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
85
86
Table
5.1
YEAR
NUMBER OF
DISTRACTION-RELATED MVCs
DISTRACTION-RELATED
MVC FATALITIES
2008
5,902
91
2009
5,714
99
2010
6,289
102
2011
6,038
79
2012
6,201
80
Notes: "Distraction-related" fatalities are deaths where one or more vehicles involved in the crash had any one of the contributing factors: use of
communication/video equipment, driver internal/external distraction, and/or driver inattentive. Data are based on police reports from
police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g.,
vehicle design or roadway design). See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012 (March 2014).
Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
5.1
3.0
450
2.5
Number of Fatalities
400
350
2.0
300
250
1.5
200
1.0
150
100
0.5
50
0
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
440
452
402
411
354
363
364
292
280
269
76
114
85
98
91
99
102
79
80
77
1.8
2.7
2.0
2.3
2.1
2.2
2.3
1.8
1.8
1.7
17.3
25.2
21.1
23.8
25.7
27.3
28.0
27.1
28.6
28.6
Figure
0.0
Year
Notes: "Distraction-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: use of
communication/video equipment, driver internal/external distraction, and/or driver inattention. Data are based on police reports from police-attended
motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g., vehicle design, roadway
design). See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
2004-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
t
u
87
Figure
5.2
9
8
7
6
5
4
3
2
1
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.3
3.1
2.1
2.5
2.9
2.3
2.8
6.5
Female
0.4
1.8
1.2
1.1
1.6
1.2
1.6
3.7
BC
0.3
2.4
1.6
1.8
2.2
1.8
2.2
4.9
Age Group
Notes: "Distraction-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: use of
communication/video equipment, driver internal/external distraction, and/or driver inattentive. Victim may or may not be the distracted person involved in
the crash. Rates are calculated using age- and sex-specific population numbers. There were five cases where age group and/or sex was missing, and these
cases are excluded from this figure. Data are based on police reports from police-attended motor vehicle crashes; therefore, contributing factors reported
emphasize human error rather than other systemic factors (e.g., vehicle design, roadway design). See Appendix B for more information about these data
sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
88
Figure
5.3
Fatality Rate per 100,000 Population
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Male
1.9
3.2
3.0
2.6
2.5
2.6
2.4
2.1
2.1
2.0
Female
1.5
1.7
0.8
1.5
1.1
1.5
1.6
1.0
1.0
1.1
BC
1.7
2.5
1.9
2.1
1.8
2.0
2.0
1.5
1.5
1.6
Year
Notes: "Distraction-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: use of
communication/video equipment, driver internal/external distraction, and/or driver inattentive. Victim may or may not be the distracted person involved in
the crash. Age-standardized rates are calculated using Canada 1991 Census population. There were 14 cases where age group and/or sex was missing, and
these cases are excluded from this figure. Data are based on police reports from police-attended motor vehicle crashes; therefore, contributing factors
reported emphasize human error rather than other systemic factors (e.g., vehicle design, roadway design). See Appendix B for more information about
these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2004-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
89
Figure
5.4
Notes: These roadway signs were introduced in BC in 2010 with the new distracted driving legislation. Reproduced with permission.
Source: BC Ministry of Transportation and Infrastructure, CC BY-NC-ND 2.0 (see: https://creativecommons.org/licenses/by-nc-nd/2.0/).
Two limitations to this study were that the sample was not representative, and it only counted cell phone use if the device was
being held up to the drivers ear.
90
SUBSTANCE-BASED IMPAIRMENT
Substance-based impairment includes both
alcohol impairment and drug impairment
(both legal and illegal drugs). Even in small
amounts, alcohol and other psychoactive
substances can impair driving performance.26,27
The risk of an MVC increases with the amount
of alcohol and other drugs consumed and from
combining alcohol and other drugs.28,29,30
These substances include alcohol,
prescription medication, over-the-counter
medications (whether their use is legal or
illicit), and illegal drugs.
Effects of Impairment
The effects of medications on driving ability
vary by medication, and effects can include
sleepiness, impaired vision, dizziness,
decreased reaction time, fainting, and/or
difficulty concentrating.31,32 Prescription
and over-the-counter medications such as
benzodiazepines,33 opioids, antihistamines,
and cough and cold remedies may
impair cognitive function and/or driving
performance.31,34,35 Any symptoms or
effects may also be worsened when multiple
medications are taken concurrently or are taken
in conjunction with alcohol or other drugs.36,37
Alcohol and other drugs also have an array
of effects. Depressants and barbiturates can
reduce motor coordination and reaction
times, cause blurred or double vision, and
impair depth perception.36 Stimulants such
as amphetamines and cocaine may lead
Alcohol Impairment
Alcohol is a depressant and affects judgment,
which can lead to poor decision-making
and reckless driving. Research has found
that alcohol consumption increases both
the probability of an MVC occurring and
the probability that an MVC will result in a
fatality or serious injury.43 The risk associated
with driving while impaired has clearly been
shown to increase as blood alcohol content
(BAC)x (also known as blood alcohol
concentration) increases.
In BC, drivers are considered impaired by
alcohol and can face administrative sanctions
if they have a 0.05 BAC or higher (50 mg of
alcohol per 100 mL of blood).44,45 Canadas
Criminal Code sets the legal limit for drivers
at 0.08 BAC, meaning that drivers who have
a BAC over 0.08 are committing a punishable
criminal offence.46 BAC is typically
determined through breath testing, because
the amount of alcohol in a persons breath
has been shown to directly correlate with the
amount of alcohol in a persons blood, and
alcohol breath testing is readily available for
roadside use by enforcement officers.
w
x
91
Drug Impairment
5.5
200
180
0.05 BAC Level of
Impairment
160
Increase in Risk
140
120
100
86.9
80
60
Age Group
50.4
40
5.3
20
1519 years
30.4
3.0
2029 years
17.5
1.0
30+ years
16.5
5.8
0
0
10
20
30
40
50
60
70
80
90
100
110
120
130
140
150
92
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
93
Figure 5.6 shows the number of impairedrelated MVC fatalities in BC from 1996 to
2013. It shows that although there has been
variation from year to year, the number and
rate of impaired-related MVC fatalities has
generally decreased from 1996 to 2013, with
the rate in 2013 being just over one-third
of the rate in 1996. The lowest count and
rate was in 2012, at 57 and 1.3 fatalities
per 100,000 population, respectively. This
improvement likely reflects both a culture
change in attitude towards impaired driving
and the Immediate Roadside Prohibition
(IRP) program introduced in 2010 (see
next section for further detail). These
improvements are successes for BC; however,
this figure also shows that impairment is
still a factor in nearly one-quarter of MVC
fatalities in BC in recent years.
Figure
5.6
450
3.5
Number of Fatalities
400
3.0
350
2.5
300
2.0
250
200
1.5
150
1.0
100
0.5
50
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
469
429
429
409
396
394
457
448
440
452
402
411
354
363
364
292
280
269
150
133
136
106
102
122
123
111
125
140
131
144
112
106
127
75
57
63
3.9
3.4
3.4
2.6
2.5
3.0
3.0
2.7
3.0
3.3
3.1
3.4
2.6
2.4
2.8
1.7
1.3
1.4
32.0
31.0
31.7
25.9
25.8
31.0
26.9
24.8
28.4
31.0
32.6
35.0
31.6
29.2
34.9
25.7
20.4
23.4
0.0
Year
Notes: "Impaired-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: alcohol involvement, prescribed medication, and/or drug involvement
listed. Victim may or may not be the impaired person involved in the crash. Data are based on police reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize
human error rather than other systemic factors (e.g., vehicle design, roadway design). See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 1996-2013; population estimates are from the BC Stats website,
April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
94
4.0
500
Figure
5.7
7
6
5
4
3
2
1
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Male
5.8
5.3
5.5
4.4
4.0
4.8
4.8
4.3
4.8
4.7
5.1
5.3
4.0
3.6
4.3
2.5
2.2
2.3
Female
2.1
1.5
1.4
1.1
1.2
1.4
1.4
1.1
1.3
2.3
1.4
1.5
1.1
1.3
1.6
0.9
0.4
0.4
BC
4.0
3.4
3.5
2.8
2.6
3.1
3.1
2.7
3.1
3.5
3.3
3.4
2.5
2.4
2.9
1.7
1.3
1.4
Year
Notes: "Impaired-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: alcohol involvement,
prescribed medication, and/or drug involvement listed. Victim may or may not be the impaired person involved in the crash. Age-standardized rates are
calculated using Canada 1991 Census population. There were 28 cases where age group and/or sex was missing, and these cases are excluded from this
figure. Data are based on police reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather
than other systemic factors (e.g., vehicle design, roadway design). See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 1996-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Figure
5.8
8
7
6
5
4
3
2
1
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.3
6.3
4.8
3.2
3.0
2.4
0.9
1.1
Female
0.2
2.4
1.1
1.3
0.7
0.3
0.2
0.4
Age Group
Notes: "Impaired-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: alcohol involvement,
prescribed medication, and/or drug involvement listed. Victim may or may not be the impaired person involved in the crash. Rates are calculated using
age- and sex-specific population numbers. There were fewer than five cases where age group and/or sex was missing, and these cases are excluded from
this figure. Data are based on police reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error
rather than other systemic factors (e.g., vehicle design, roadway design). See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
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95
96
2. Limit Access
Some interventions that limit access to
alcohol have been shown to be effective in
reducing the likelihood that people will
drive while impaired by alcohol. Measures
can include raising the cost of alcohol
(e.g.,higher alcohol taxes) to create economic
barriers;65 prohibiting and/or limiting the
sale of alcoholic drinks in restaurants, shops,
and service stations along roadways, which
creates logistical barriers;66 and requiring
training programs for servers of alcoholic
beverages to limit access to alcohol by
intoxicated people.67 Studies have shown
decreased alcohol-impaired MVC fatalities
associated with increased economic barriers
to accessing alcohol65 and training servers to
limit access to intoxicated people.67
5. Increase Penalties
The United Nations recommends penalties be
part of a comprehensive strategy to deter people
from driving while impaired.66 In BC, when
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
97
IRPs for impaired drivers were temporarily suspended in 2011 after a BC Supreme Court judge ruled that the program in part
violated constitutional rights. Related legislation was amended and the suspension was lifted in May 2012.
y
98
PHYSICAL OR COGNITIVE
IMPAIRMENT
Safe operation of a motor vehicle requires
reliable sensory, cognitive, and motor
functions. In addition to impairment from
substance use, drivers can also be subject
to physical impairment or cognitive
impairment, as is the case with medicallyat-risk drivers and drivers impaired by
drowsiness or fatigue. Individuals whose
mental or physiological conditions may
compromise their ability to drive safely
are at increased risk of MVC involvement
and resulting serious injury or fatality.113
Detecting these forms of impairment may
be difficult and relies heavily upon selfawareness; self-detection; and/or feedback
from a drivers friends, family, and medical
professionals.
Medically-At-Risk Drivers
Medically-at-risk drivers are drivers who may
be impaired due to medical conditions that
impede their ability to drive a vehicle safely.
Driving is a complex task that requires a
combination of vision, cognitive, and motor
functions.114 Individuals with impaired
vision may lack the ability to perceive
visual details necessary for safe driving. For
example, visual field impairments, loss of
contrast sensitivity, loss of depth perception,
double vision, and visual perceptual
difficulties, all impair a drivers ability to
identify risks on the road and operate a
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
99
Although fatigue, drowsiness, and other forms of sleep-related impairment may be defined separately, they are also sometimes
used interchangeably; hereafter, fatigue will be used as a catch-all term for forms of sleep-related impairment, unless otherwise
specified in the literature cited.
100
Table
5.2
PROPORTION OF
FATALITIES
Extreme Fatigue
29
1.8%
Fell Asleep
53
3.2%
0.5%
Note: Fatigue and falling asleep are self-reported. Victim may or may not be the impaired person involved in the crash. Data are based on police
reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic
factors (e.g., vehicle design, roadway design). See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012; prepared by BC Injury
Research and Prevention Unit, 2014.
This was a random sample, but it captured a very small sample size of commercial truck drivers (N=67). Therefore, these data
should be interpreted with caution.
aa
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101
DriveABLE Assessments in BC
RoadSafetyBC is responsible for making drivers licensing
decisions based on the effect(s) of a medical condition
on a persons ability to drive. When RoadSafetyBC
receives a report of a driver with cognitive impairment
from a physician, family member, police officer, or
other individual, that driver may be referred for further
assessments. For some, further assessments may entail
a DriveABLE cognitive assessment to measure driving
ability.139 About 1,500 BC drivers are referred for a
DriveABLE assessment each year.142
The DriveABLE in-office computerized assessment
evaluates a drivers attention, judgment, decision-making,
motor skills, and memory.ab,140 If they fail, they have an
opportunity to take an onroad evaluation. Results are
submitted to RoadSafetyBC, where an adjudicator or
nurse case manager reviews all of the information and
makes a licensing decision.139
ab
The DriveABLE assessment is a computerized program and it has been criticized by some seniors advocates as being unfair for
older drivers who may not be comfortable using computers.
102
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103
HIGH-RISK DRIVING
High-risk driving is driving a vehicle
aggressively or in a way that may harm
property or another person. High-risk
drivers also refer to individuals who
incur more driving violations than average
drivers.1 High-risk driving may include
risk-taking behaviour or outright hostile
behaviour toward another individual.150
Drivers with previous licence suspensions
and multiple atfault crashes are more
likely to cause future crashes and have a
much higher crash risk compared to other
drivers.1
The Royal Canadian Mounted Police
(RCMP) identify high-risk driving as one
of the top three road safety concerns in
BC, along with seat belt use and impaired
driving.150 High-risk driving includes
driving behaviours such as failing to yield,
ignoring traffic-control devices, following
too closely, speeding, and improper
passing.151 Table5.3 shows the proportion
and number of MVC fatalities with highrisk driving behaviours as contributing
factors. Speeding is the most common highrisk driving behaviour,and was a factor in
Table
5.3
HIGH-RISK DRIVING
BEHAVIOUR TYPE
NUMBER OF
FATALITIES
PROPORTION
OF FATALITIES
14
0.8%
Improper Passing
56
3.4%
86
5.2%
141
8.5%
Speeding
577
34.9%
Notes: Victim may or may not be the high-risk driver involved in the crash. See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012; prepared by BC Injury
Research and Prevention Unit, 2014.
104
SUMMARY
Road user behaviours and impairment
have a significant impact on road safety.
Impairment includes road user distraction;
substance-based impairment (alcohol and
other drugs, including prescription and
over-the-counter medications); physical or
cognitive impairment (this includes medically
at-risk drivers, age-related cognitive or sensory
impairments, and driving while fatigued),
and high-risk driving. As discussed in this
chapter, males are at increased risk for motor
vehicle crash (MVC) fatalities related to
some of these behaviours and conditions,
particularly distracted driving, substanceimpaired driving, and high-risk driving.
Further, impairment-related MVC fatalities
are overwhelmingly experienced by youth
age 16-25, especially males. Recognizing and
addressing problematic driver behaviours and
impairment can help to improve the health
and safety of all road users. Strategies that
combine public education and awareness,
legislation and enforcement, and penalties
for unsafe behaviours can help to reduce
the burden of MVCs and related injuries
and fatalities on BC roads. For maximum
effectiveness, such strategies should focus on
higher-risk populations, such as young and
new drivers, male drivers, commercial drivers,
and those who are medically at-risk.
The next chapter will investigate the role of
safe speeds in promoting road safety in BC.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
105
106
Chapter 6
Safe Speeds
INTRODUCTION
Speed is the top road safety problem in many
countries.1 Globally, it is an aggravating
factor in the severity of all motor vehicle
crashes (MVCs) and the causal factor in
about one-third of fatal MVCs.1Safe speed
is one of the four pillars of a Safe System
Approach (SSA) and is closely linked
with the other pillars. Interventions to
prevent speeding or reduce the severity of
speed-related MVCs focus on road user
behaviour, roadway engineering, and vehicle
modifications. This chapter provides an
overview of speed in BC, including relevant
laws, enforcement, and trends. It examines
the burden of speed-related MVCs in BC in
relation to serious injuries and fatalities. The
chapter concludes with a discussion about
options for speed management in BC.
Speeding in BC includes driving faster
than the designated speed limit and driving
too fast for the conditions (which may
be lower than a posted limit). Excessive
speeding is defined in the BC Motor Vehicle
Act as driving more than 40 km/h over
the speed limit.3 Default speed limits in
BC are designated in the Act as 50 km/h
in municipalities and 80 km/h outside of
municipalities.3 The speed limit near schools
and playgrounds is 30 km/h when signs are
present and within specified hours. While
these speed limits are static and applicable
on all roads in BC, both municipalities
and the Minister of Transportation and
Infrastructure have legislated power to
modify speed limits.4 For example, some
highways in BC have speed limits as high as
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107
108
BURDEN OF SPEED-RELATED
MVCS IN BC
In BC from 2006 to 2013, speed was the top
contributing factor cited in police reports
for police-attended MVCs in which there
was a fatality. Only in 2013 was this factor
surpassed by driver distraction.ac,15
As shown in Figure 6.1, over the last 18 years
the number of MVC fatalities overall has
decreased substantially, from 469 in 1996 to
269 in 2013. The number of speed-related
fatalities was highest in 2002 and 2005 (at
183 and 181, respectively) and has been
generally decreasing since 2005, down to
78 in 2013. Similarly, the speed-related
proportion of MVC fatalities has been
decreasing in recent years and reached its
lowest proportion in 2013, at 29.0 per cent.
Figure
Number of Fatalities
500
5.0
450
4.5
400
4.0
350
3.5
300
3.0
250
2.5
200
2.0
150
1.5
100
1.0
50
0.5
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
469
429
429
409
396
394
457
448
440
452
402
411
354
363
364
292
280
269
171
157
153
139
155
165
183
161
146
181
146
167
133
133
113
98
100
78
4.4
4.0
3.8
3.5
3.8
4.0
4.5
3.9
3.5
4.3
3.4
3.9
3.1
3.0
2.5
2.2
2.2
1.7
36.5
36.6
35.7
34.0
39.1
41.9
40.0
35.9
33.2
40.0
36.3
40.6
37.6
36.6
31.0
33.6
35.7
29.0
6.1
0.0
Year
Notes: "Speed-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: unsafe speed,
exceeding speed limit, excessive speed over 40 km/h, and/or driving too fast for conditions. Data are based on police reports from police-attended motor
vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g., vehicle design, roadway design).
See Appendix B for more information about these data sources.
Source: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and
Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
As noted in earlier chapters of this report, these contributing factors are based on police reports from police-attended MVCs, so
they emphasize human factors rather than other systemic factors.
ac
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
109
Figure
6.2
Passenger Vehicle
Passenger
29.5%
49.6%
15.1%
Motorcycle Occupant
Passenger Vehicle
Driver
4.4%
0.4%
Other
1.0%
Cyclist
Pedestrian
Notes: "Passenger vehicle" includes cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle
occupant" includes motorcycle drivers and passengers. "Speed-related" fatalities are deaths where one or more vehicles involved in a crash had any one of
the contributing factors: unsafe speed, exceeding speed limit, excessive speed over 40 km/h, and/or driving too fast for conditions. Data are based on police
reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors
(e.g., vehicle design, roadway design). See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
110
Figure
6.3
8
7
6
5
4
3
2
1
0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.7
6.9
4.6
3.8
3.3
2.2
1.6
2.8
Female
0.4
3.5
1.6
1.3
1.1
0.8
1.2
0.6
Age Group
Notes: "Speed-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: unsafe speed, exceeding
speed limit, excessive speed over 40 km/h, and/or driving too fast for conditions. Rates are calculated using age- and sex-specific population numbers. There
were fewer than five cases where the age group was missing, and these cases are excluded from this figure. Data are based on police reports from
police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g., vehicle
design, roadway design). See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Figure
6.4
9
8
7
6
5
4
3
2
1
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Male
7.0
6.0
6.0
5.3
5.6
6.1
7.1
6.1
5.3
7.1
5.2
5.7
4.4
4.7
3.6
2.7
3.1
2.6
Female
2.0
2.1
2.0
1.7
2.1
2.1
1.9
1.8
2.0
1.9
2.0
2.1
1.6
1.2
1.4
1.7
1.5
1.1
BC
4.5
4.1
4.0
3.5
3.9
4.1
4.5
4.0
3.6
4.5
3.6
3.9
3.0
3.0
2.5
2.2
2.3
1.8
Year
Notes: "Speed-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: unsafe speed,
exceeding speed limit, excessive speed over 40 km/h, and/or driving too fast for conditions. Age-standardized rates are calculated using Canada 1991
Census population. There were 33 cases where the age group and/or sex was missing, and these cases are excluded from this figure. Data are based on
police reports from police-attended motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic
factors (e.g., vehicle design, roadway design). See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
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111
Table
6.1
PROPORTION OF
MVC FATALITIES
Impairment-related
(speed not a factor)
232
14.8%
Speed-related
(impairment not a factor)
326
20.8%
196
12.5%
Total
(impairment- and/or speed-related)
754
48.1%
CONTRIBUTING FACTOR
Notes: "Impaired-related" fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: alcohol
involvement, prescribed medication and/or drug involvement. Victim may or may not be the impaired person involved in the crash. "Speed-related"
fatalities are deaths where one or more vehicles involved in a crash had any one of the contributing factors: unsafe speed, exceeding speed limit,
excessive speed more than 40 km/h above speed limit, and/or driving too fast for conditions. Data are based on police reports from police-attended
motor vehicle crashes; therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g., vehicle design,
roadway design). See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 1996-2013; prepared by BC Injury
Research and Prevention Unit, 2014.
112
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113
Sample of Signage in BC
6.5
New maximum
speed limit in BC
Keep Right
signage
Notes: These roadway signs were introduced in BC in 2014 and 2015. Reproduced with permission.
Source: BC Ministry of Transportation and Infrastructure, CC BY-NC-ND 2.0 (see: https://creativecommons.org/licenses/by-nc-nd/2.0/).
114
ad
This is a crude rate, calculated based on 3,648 MVC fatalities in a population of 82,302,468 in 2010.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
115
Table
6.2
SURVIVABLE SPEED
30 km/hr
50 km/hr
Vehicle occupant in a
front-impact MVC
70 km/hr
100 km/hr
Sources: Adapted from: Arason N. 2014. No Accident: Eliminating Injury and Death on Canadian Roads; 62 and Tingval C, Haworth N. 1999. Vision Zero-An
Ethical Approach to Safety and Mobility.63
116
Speed Cameras
Speed cameras, also known as photo radar,
detect when a vehicle is speeding using laser
or radar technology and photograph the
speeding vehicle. Tickets are then issued to
the owner of the vehicle based on registration
information obtained from the photographed
licence plate. Speed cameras are used all
over the world (e.g.,the Netherlands, New
Zealand, Australia, France, and the UK).1
There are many ways that speed cameras
can be deployed. They can be fixed at
one location or be mobile (which makes
enforcement unpredictable and broadens
deterrence); they can be operated by trained
personnel or have automated functionality;
they can be used on different types of
roadways; they can be visible or hidden; and
they can have different speed enforcement
thresholds.48 The effectiveness of speed
cameras has been widely studied1 since they
were first introduced in Norway in 1988.49
According to a 2009 Cochrane Review,
117
118
Section Control
Section control, also known as point-topoint speed enforcement, average speed
enforcement, and time-over-distance
cameras, has been used in some countries
since the late 1990s and works by measuring
the average speed of a vehicle on a section
of road. The average speed is calculated
based on the length of the section of road
and the time it takes the vehicle to travel
through that section, as determined by timestamped photographs taken of the vehicle
as it enters and leaves the section.52 Section
control is designed to facilitate reduction
of speed across a whole section of road,
rather than just one spot (as with speed
cameras).53 It is usually implemented across
a section of road measuring 2 to 5 km. It
can be operated 24hours a day, resulting
in a greater likelihood of speeders being
caught,54 and enforcement can be set for any
given threshold to allow for small or large
variations in speed.55
In 2008, the OECD reported that section
control was in use in the Netherlands,
Switzerland, Australia, the UK, Austria,
and the Czech Republic.1 A 2012 review
of international literature on section
control found that this method of speed
control resulted in increased compliance
with posted speed limits, reduced speeds,
reduced levels of excessive speeding, and
decreased speed variability among vehicles.
The comprehensive review included
consultations with Australian, New Zealand
and international stakeholders. This work
resulted in 34 best practice recommendations
to guide implementation efforts, including
operational technology, legislation,
public education, evaluation, and privacy
recommendations.56 Another international
literature review in 2012 associated this
technology with decreased rates of MVCs, as
well as reduced related fatalities and serious
injuries. Other positive impacts included
119
SUMMARY
120
Chapter 7
Safe Roadways
INTRODUCTION
In addition to safe road user behaviour
and safe speeds, safe roadways are a crucial
component of road safety. In fact, some
evidence indicates that the most effective way
to reduce trauma to road users is through
better designed roads and vehicles.1 Roadway
design includes highway lane separation,
guard rails, paved shoulders, rumble strips,
roundabouts, roadway lighting, and
more.2 Within a Safe System Approach
(SSA), safe roadways are roads and related
infrastructure that are designed around road
users, encourage safe driving behaviour, and
anticipate road user error.3 In addition to
reducing roadway traumas, safe roadways
are important for public health and healthy
living. Urban planning, transportation
infrastructure, neighbourhood density,
and the development of safe environments
for schools, parks, and other amenities
influence how people behave, including
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121
122
Intersections
An intersection is an area where two
or more roads cross each other.20 Types
of intersections range from single stop
sign intersections to urban signal-lightcontrolled intersections, to complex freeway
interchanges. Intersections represent one of
the most complex traffic situations that road
users encounter, because they require all road
users to pay attention and respond to the
movements of vehicles and other road users,
as well as adherence to traffic signals.21
MVCs commonly occur at intersections
because there are many potential points
of conflict between vehicles, in addition
to those between vehicles and pedestrians
and other road users (see Figure 7.1).21 In
addition, these MVCs are potentially more
severe because they often involve a side
impact, for which vehicles typically offer less
protection than a head-on collision,22 and
Figure
7.1
Conflict Types
Crossing (16)
Diverging (8)
Same direction travel paths that
move away from each other
Converging (8)
Notes: "Intersection" includes both common roadway intersections and junctions of intersecting highways.
Source: Adapted from City of Chilliwack. Roundabouts FAQs.23
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123
Figure
500
450
3.0
Number of Fatalities
400
2.5
350
300
2.0
250
1.5
200
150
1.0
100
0.5
50
0
Number of MVC Fatalities
Number of MVC Fatalities at Intersections
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
469
429
429
409
396
394
457
448
440
452
402
411
354
363
364
292
280
269
113
89
105
96
83
86
95
94
118
103
79
78
67
85
62
66
77
0.0
79
2.9
2.3
2.6
2.4
2.1
2.1
2.3
2.3
2.8
2.5
1.9
1.8
1.5
1.9
1.4
1.5
1.7
1.7
24.1
20.7
24.5
23.5
21.0
21.8
20.8
21.0
26.8
22.8
19.7
19.0
18.9
23.4
17.0
22.6
27.5
29.4
Year
Notes: "Intersection" includes junctions of intersecting highways. See Appendix B for more information about these data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia,
1996-2013; population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population
Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
124
7.2
Figure
7.3
Passenger Vehicle
Passenger
Passenger Vehicle
Driver
14.6%
30.6%
Motorcycle Occupant
15.4%
Other
1.4%
6.5%
31.4%
Cyclist
Pedestrian
Notes: "Passenger vehicle" includes cars, trucks, sport-utility vehicles, commercial vehicles and heavy trucks, and excludes motorcycles. "Motorcycle
occupant" includes motorcycle drivers and passengers. Intersection includes junctions of intersecting highways. See Appendix B for more information
about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
Figure
Pedestrian Fatality Rate per 100,000 Population for Motor Vehicle Crashes
at Intersections, by Sex and Age Group, BC, 2009-2013
7.4
Fatality Rate per 100,000 Population
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
0-15
16-25
26-35
36-45
46-55
56-65
66-75
76+
Male
0.1
0.5
0.3
0.1
0.2
0.3
0.3
3.6
Female
0.2
0.4
0.2
0.2
0.6
0.7
1.5
1.7
BC
0.1
0.5
0.2
0.2
0.4
0.5
1.0
2.5
Age Group
Notes: "Intersection" includes junctions of intersecting highways. Rates are calculated using age- and sex-specific population numbers. There were fewer
than five cases where age group and/or sex was missing, and these cases are excluded from this figure. See Appendix B for more information about these
data sources.
Sources: Fatality data are from the Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2009-2013;
population estimates are from the BC Stats website, April 2015. Prepared by BC Injury Research and Prevention Unit, 2014; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
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125
Highways
Highways are major roadways that are
designed for large volumes of traffic,
including commercial transport vehicles,
moving intra-provincially, inter-provincially,
and/or internationally. Larger highways are
often called freeways or expressways because
speed limits are typically higher than on
local roads.27 In 2013, over 7,000 km of
BCs 71,000 km of public roads were part
of the National Highway System (nationally
identified inter-provincial and international
routes that support trade and travel).5 In
BC for 2008-2012, 32.9 per cent of MVC
fatalities, where the posted speed limit was
known, occurred on highways with a posted
speed of 90 km/hr or above.17 Since vehicles
travel at higher speeds on highways, they
are associated with greater forces of impact
during an MVC, and therefore a greater
potential for serious injury and death. Many
highways in BC are in rural and remote
areas, especially in northern regions of the
province. MVCs in these areas have unique
issues related to their remote locations (this
will be explored further in the following
section) and concerns such as contact with
wildlife, which will also be discussed later in
this chapter.
126
ROADWAY ENVIRONMENTAL
CONTRIBUTING FACTORS TO MVCS
IN BC
Environmental conditions affect the ability
of road users to safely navigate the roadway.
Roadway design can also be a contributing
factor, such as sharp or blind corners.
Changes in conditions can quickly reduce
the safety of a roadway, so it is important
for roadways to be designed and maintained
with the surrounding landscape in mind,
including potential weather conditions and
the presence of wildlife.
For the five-year period of 2008-2012, police
reports noted one or more environmental
contributing factors to MVCs in
23.7percent of MVC fatalities in BC.33
Figure7.5 presents fatal crashes with at least
Figure
7.5
250
Number of Fatalities
200
150
100
50
0
Road
Condition
Weather
Sunlight
Glare
Animal
Road/
Intersection
Design
220
137
23
23
21
Percentage among
Environment-related MVC Fatalities
56.3
35.0
5.9
5.9
5.4
Environmental Factor
Notes: "Road condition" includes ice, snow, slush, and/or water on the road. "Weather" includes fog, sleet, rain, and snow. "Animal" includes both domestic
and wild animals. "Road/intersection design" includes locations an attending police officer believes consistently present a problem, such as roadway curves,
limited sign distance, inadequate lanes or lane width, sight distance obstruction, or traffic control issues. Data are based on police reports from
police-attended motor vehicle crashes (MVCs); therefore, contributing factors reported emphasize human error rather than other systemic factors (e.g.,
vehicle design, roadway design). Percentages will not add to 100 as less common factors are not shown, and MVCs can have more than one contributing
factor assigned. See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
In many cases these factors are related, but they are documented as separate contributing factors. For example, during snowfall,
snow may be a weather condition (due to reduced visibility) and/or a road condition (due to snow on the road); once snow stops
falling but has accumulated on the ground it would be a road condition only.
ae
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
127
7.6
500
450
350
1.5
300
250
1.0
200
150
100
0.5
50
0
2.0
400
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
394
457
448
440
452
402
411
354
363
364
292
280
Number of Environment-related
MVC Fatalities
85
92
75
85
91
85
86
79
79
77
73
83
2.1
2.2
1.8
2.0
2.2
2.0
2.0
1.8
1.8
1.7
1.6
1.8
Environment-related Proportion
of Fatalities
21.6
20.1
16.7
19.3
20.1
21.1
20.9
22.3
21.8
21.2
25.0
29.6
0.0
Year
Notes: "Environment-related" fatalities are deaths where one or more vehicles involved in the crash had any of the contributing factors:
obstruction/debris on the road, roadway surface defects, artificial glare, previous traffic accident, roadside hazard, site line obstruction, road/intersection
design, sunlight glare, animal, weather, road condition, visibility impaired, road maintenance/construction, sign obstruction, domestic and wild animal,
insufficient traffic controls, and defective/inoperable traffic control device. Data are based on police reports from police-attended motor vehicle crashes, so
contributing factors reported emphasize human error rather than other systemic factors (e.g., vehicle design, roadway design). See Appendix B for more
information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2001-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
128
Figure
Wildlife
Highways in BC cut though many wildlife
habitats. In BC, wildlife are involved in
one out of every 25 MVCs,16 and there
is an average of 9,900 MVCs involving
animals, both wild and domestic, each
year.16 According to the Wildlife Accident
Reporting System (WARS), a system
administered by MoTI that tracks MVCs
involving wildlife on numbered highways,
more than 109,000 wildlife MVCs have
been reported on BC highways since 1978,
over 90 per cent of which involved elk,
moose, bears, and deer. Some wildlife,
such as deer, prefer to travel along
open areas close to coverqualities of
many BC highways.37 In addition, some
animals might be attracted to highways
to access salt licks, mineral deposits that
accumulate on roadsides, through natural
occurrence or through the use of deicing
compounds.38 While there are some
measures in place to prevent vehicle-wildlife
interactions, BC roadways would benefit
from further preventive initiatives related
to roadway design. (See discussion in next
section for further details.)
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129
For more information about specific road infrastructure initiatives underway, see http://www2.gov.bc.ca/assets/gov/driving-and-transportation/driving/publications/
road-safety-strategy.pdf.
af
130
Traffic Calming
According to Transport Canada, traffic
calming is the modification of a roadway
and its design in a way that is intended to
reduce traffic and/or decrease speed. Safety
can also be increased by implementing
changes that aim to minimize the negative
impacts of vehicle use, reduce traffic
volume, change drivers behaviours,
lower speeds, and reduce conflict between
road users with improved conditions for
pedestrians and cyclists.48 Traffic calming
can be focused on fixing isolated parts of a
roadway (e.g.,an intersection with a high
volume of complaints or high incidence of
MVCs), or implemented across a broader
area. Examples of traffic calming include the
creation of one-way, one-lane streets; the
addition of roundabouts designed to protect
pedestrians and cyclists; and the addition
of speed humps, rumble strips, low speed
limits, and more.49,50
ag
The World Health Organization has sourced this information from a 2008 Organisation for Economic Co-operation and
Development document entitled Towards Zero: Ambitious Road Safety Targets and the Safe System Approach.
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131
There are several specific types of trafficcalmed roads. For example, environmental
streets use a variety of built elements,
usually aesthetically rendered, to calm and
slow traffic, and encourage driver attention
(such as planter boxes, pedestrian refuges
on road crossings, and raised pedestrian
crosswalks). Urban play streets are
residential streets designed for play rather
than vehicles and only residential vehicles
are permitted to drive (at very low speeds)
on them.50 Two analyses of studies in a
variety of European countries show these two
traffic-calming techniques reduced injury
MVCs by 35 per cent (studies in Denmark,
Norway, Germany, Sweden, France, and
Great Britain) and 25 per cent (studies in
Norway, Germany, The Netherlands, and
Denmark), respectively.50 Another trafficcalming approach most commonly used
in commercial centres is the inclusion of
pedestrian streets, which are roads for
pedestrian use (and often bicycles) that
are closed to motor vehicle traffic.50 A
collection of European studies (Sweden,
Norway, Finland, Denmark, and Great
Britain) together have shown an estimated
60percent reduction in MVCs resulting
from the introduction of pedestrian streets.50
Most traffic calming is on minor streets in
residential areas.48 Traffic-calmed areas in
North America can be more accommodating
of the other activities that take place on
the road including playing, walking, and
socializing. Traffic calming also helps to
address public health issues associated with
traffic noise, and low rates of walking,
cycling, and transit use.48 Encouraging active
transportation (e.g., walking or cycling to
work or school) and making it a safe, viable
option works both to improve health and
to reduce the number of vehicles on the
road, which then has further road safety and
environmental benefits.
Cycling Infrastructure
Infrastructure that is designed with cycling
in mind offers considerable safety benefits to
this group of vulnerable road users; indeed,
132
Figure
7.7
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133
134
Figure
7.8
Notes: Photo credit The City of Richmond, BC. Reproduced with permission.
Source: The City of Richmond, BC.
The City of Richmond received mostly positive feedback about the scramble in the first year. Notably, in the first year after
installation, the city adjusted the signalling at the intersection to resolve concerns over the safety of visually impaired pedestrians
using the crosswalk, and concerns over traffic delays due to the initial no-right-turn-on-red signalling.
ah
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
135
Barriers
Roadway barriers have the potential to
reduce the number of single-car and head-on
MVCs. Barriers can be installed either on
the centre of the road (median barriers), or
on the side of the road (guardrails). Median
barriers are intended to separate lanes of
traffic travelling in different directions and
are designed to reduce head-on collisions.92
Barriers come in three general categories:
rigid, semi-rigid, and flexible. The type used
depends on the types of vehicles that use the
road, the potential severity of the MVCs, and
the roadway geometry.92 Rigid barriers are
often made of concrete, are effective, and are
easy to maintain. However, they are costly
to install and have the potential to cause
more severe injuries on impact due to their
rigidity.92 More flexible barriers (e.g., steel or
wire) are also available, and some areas of BC
have cable barriers. They reduce the number
of injuries related to MVCs,50 absorb more
136
Rumble Strips
Rumble strips are used to prevent roadway
departure, commonly referred to as driving
off the road.93,94 Rumble strips are a series of
ridges and grooves in the pavement usually
located at the centreline or outside edge of
Figure
7.9
Notes: These photos are cropped to feature the rumble strips. Reproduced with permission.
Source: BC Ministry of Transportation and Infrastructure, CC BY-NC-ND 2.0 (see: https://creativecommons.org/licenses/by-nc-nd/2.0/).
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
137
Figure
7.10
138
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
139
SUMMARY
140
Chapter 8
Safe Vehicles
INTRODUCTION
Safe vehicles form another of the four
pillars of the Safe System Approach (SSA)
to road safety. A safe vehicle is designed to
prevent motor vehicle crashes (MVCs) and
reduce the severity of an MVC if one does
occur.1 Three key components of vehicle
safety are vehicle design standards, vehicle
technologies, and vehicle maintenance.
These components reflect the SSA principle
that road safety is a shared responsibility
among manufacturers, regulators, and road
users, among others.2 Consumer demand
and industry regulation have led to vehicle
safety improvements over the past century.3
Safety improvements have generally included
enhancements to vehicle design and
materials, the introduction of technologies
that help drivers avoid MVCs, and in the
event of an MVC, greater protection to
vehicle occupants from serious injuries and
fatalities through better safety features.
This chapter provides an overview of the
role that vehicles play in MVCs in BC, a
discussion of vehicle safety standards in
Canada and BC, a review of developments in
vehicle safety technologies and design, and
then briefly explores vehicle maintenance
and modifications.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
141
142
Vehicle Types
Road users in North America use a wide
variety of vehicles. These vehicles vary
by type (e.g., size, weight, design), safety
features (e.g., inclusion of crash avoidance
technologies and crash protection
technologies), age, and condition. According
to the 2009 annual Canadian Vehicle
Survey, there were about 2.7 million
registered vehicles in BC.ai,22 The vast
majority of these (94.5percent) were
light vehicles, weighing less than 4,500kg,
which include cars, station wagons, vans,
sport-utility vehicles (SUVs), and pickup
trucks.22,23 The remaining 5.5 percent
consisted of about 130,000 medium
vehicles, weighing 4,500 to 14,900 kg,
and 17,000 heavy vehicles, weighing
15,000 kg and over.22 According to the
Insurance Corporation of British Columbia,
approximately one-quarter of insured
Figure
8.1
120
Proportion of Fatalities
100
80
60
40
20
0
2008
2009
2010
2011
Panel Van
6.2
4.8
5.7
3.1
2012
6.3
Sport-utility Vehicle
9.0
8.8
9.7
8.3
17.1
Motorcycle
13.5
16.0
12.0
16.7
11.7
15.2
17.0
18.1
25.0
22.0
Passenger Car
54.3
51.4
54.2
46.1
41.0
Other
1.7
2.0
Total Fatalities
289
294
299
228
205
Year
Note: "*" Indicates rates based on numbers less than five. Vehicle type recorded refers to the vehicle the victim was in. "Truck and tractor" includes pickup
trucks, single and combined unit light and heavy duty trucks, and tow trucks. See Appendix B for more information about this data source.
Source: Police Traffic Accident System, Business Information Warehouse, Insurance Corporation of British Columbia, 2008-2012. Prepared by BC Injury
Research and Prevention Unit, 2014; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
ai
The Canadian Vehicle Survey excludes certain vehicle types, such as buses, motor homes, and motorcycles.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
143
8.2
144
Figure
8.3
2000
(16,642,140 vehicles)
SUV
2009
(19,755,915 vehicles)
Van
Pickup Truck
Other
16.1%
Station
Wagon
2.5%
SUV
Pickup Truck
6.9%
0.8%
13.2%
12.8%
Van
Station Wagon
3.5%
60.5%
Car
Car
15.2%
12.8%
Other
0.3%
55.4%
Note: Light vehicles are those with a gross vehicle weight less than 4.5 tonnes. "Other" includes straight trucks, tractor-trailers, and buses. This sample does
not include motorcycles, buses, off-road vehicles, or special equipment such as snowplows.
Source: Reproduced with permission from Natural Resources Canada. 2011. Canadian Vehicle Survey 2009: Summary Report.29 This figure is a reproduction and
adaptation of an official work that is published by the Government of Canada, and the reproduction has not been produced in affiliation with, or with the
endorsement of, the Government of Canada.
145
Improved Lights
146
Lane Use
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
147
Safe Braking
In addition to vehicles assisting drivers to
slow down or stop based on the detection of
excessive speeds or unsafe vehicle distances,
advancements in braking technologies can
also help braking take place more safely.
Electronic Stability Control (ESC) helps
a driver maintain control by preventing
skidding under most driving conditions,
including on icy, slushy, and snowy roads.62
ESC monitors the drivers use of the brake
pedal, and, when steering direction does not
match vehicle direction, ESC applies brakes
148
Passenger Restraints
Seat belts are a key contributor to the
reduction in MVC injuries and fatalities
seen over the past 30 years.77 In BC, the use
of seat belts by motor vehicle occupants has
been mandatory since 1977.aj,6,78 Seat belts
are typically a combination of a lap belt and
aj
There are currently exemptions to this law under Division 32 of the Motor Vehicle Act Regulations.
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150
Air Bags
Air bags are a vehicle safety device designed
to inflate instantly in an MVC to protect
the occupants inside the vehicle85and in
some cases vulnerable road users outside of
the vehicle86by cushioning them from hard
surfaces. Air bags can be located in a variety
of locations inside and outside of the vehicle,
but are most typically front and side air bags
found inside the vehicle.86
Front air bags are typically installed inside
the steering wheel and dashboard of a
vehicle and prevent the drivers and front
passengers heads from contacting these hard
surfaces if they are thrust forward suddenly
in an MVC.87 They are designed to be
supplementary to seat belts.88 The National
Highway Traffic Safety Administration in
the United States estimates that air bags
saved 8,369 lives from 1975 to 2001.89
Passenger air bags have shown to be
effective at reducing fatalities for frontseat passengers.90Modern vehicles provide
both head and chest protection, with the
combination of a head and torso bag or
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151
Vehicle Maintenance
Road safety necessitates that vehicles
be maintained and be in good working
condition to allow a driver to navigate and
respond to roadway conditions and events
appropriately. Good vehicle maintenance
includes the consideration of vehicle
condition and age.
N. Arason, No Accident:
Eliminating Injury and Death on
Canadian Roads 53 (p.82)
Vehicle Condition
In BC, like most Canadian provinces,
vehicle owners are responsible for the
maintenance of their vehicles;53 however,
there is no provincial practice to ensure that
vehicle owners conduct appropriate vehicle
maintenance, other than the possibility
of police ordering a safety inspection on
a vehicle they believe may be defective
or unsafe.97 Many jurisdictions in North
Figure
8.4
60
Number of Fatalities
50
40
30
20
10
0
Number of Fatalities
Percentage among Vehicle
Condition-related Fatalities
Tire Failure/
Inadequate
Brakes Defective
Windows Obstructed
Headlights
Defective/Out
52
12
56.5
13.0
8.7
7.6
152
AirCare
AirCare was a program that required vehicle owners
to pass an emissions test before being insurable in
some parts of BC. While it focused on air quality
and environmental health, it mandated vehicle
maintenance. The program was terminated in 2014
to allow for program evaluation and planning of
its future direction.99 Previous to AirCare, BC had
a mandatory vehicle inspection program that was
terminated in 1983.98 These programs demonstrate
that it is possible to require vehicle maintenance.
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153
Vehicle Age
There is currently a considerable mixture
of older and newer vehicles on the road.22
The age of vehicles can impact their general
condition and is a factor in maintenance
for optimal road safety. Research has
demonstrated that occupants of vehicle
models that are 14 or more years old are at
about three times the risk of MVC-related
injuries than occupants of newer vehicles.2
Figure
8.5
Light Vehicles
(19,755,945 total)
More than 9
Years Old
6,156,488 vehicles
Less than 3
Years Old
3,688,609 vehicles
18.7%
20.6%
31.2%
39.5%
50.2%
Between 3 and 9
Years Old
9,910,847 vehicles
39.9%
More than 9
Years Old
293,619 vehicles
Between 3 and 9
Years Old
305,585 vehicles
Notes: Light vehicles are those with a gross vehicle weight less than 4.5 tonnes, medium trucks are those 4.5 to 15 tonnes, and heavy trucks are those
more than 15 tonnes. This sample does not include motorcycles, buses, off-road vehicles, or special equipment such as snowplows. The total number of light
vehicles listed above (19,755,945) does not equal the sum of light vehicles by age (19,755,944). This discrepancy is replicated from the source document.
Source: Reproduced with permission from Natural Resources Canada. 2011. Canadian Vehicle Survey 2009: Summary Report.29 This figure is a reproduction
and adaptation of an official work that is published by the Government of Canada. The reproduction has not been produced in affiliation with, or with
the endorsement of, the Government of Canada.
154
Vehicle Modification
Modifications to a motor vehicle by its
owner, commonly referred to as aftermarket modifications, often do not comply
with the safety standards outlined in the
CMVSS. After-market modifications
may also contribute to premature failure
of steering and braking components and
reduce the effectiveness of safety features
when they are incompatible with modified
vehicle height and weight.110 However,
some after-market modifications, such as
the addition of safety features like back-up
cameras, increase the safety of a vehicle. As
will be discussed in this section, common
modifications that increase the severity of
MVC outcomes include raising the vehicle
height with lift kits110,111 or oversized tires,111
and installing bull bars.2,112,113
After-market modifications that increase
vehicle height may increase the risk of
MVCs by limiting the drivers ability to
see pedestrians, lower vehicles, and head,
tail and signal lights. Headlights on raised
vehicles are no longer at the right height for
optimal visibility, and can also distract or
visually impair other drivers.110,111 Oversized
tires can also rub the suspension, fender,
frame, and steering arm components of a
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
155
SUMMARY
156
Chapter 9
INTRODUCTION
Many improvements have been made in
the health status of Aboriginal people in
BC in recent years; however, many still
experience poorer health outcomes than
other BC residents, including higher rates
of injuries and mortalities due to motor
vehicle crashes (MVCs).1 Indeed, the average
age-standardized fatality rate for MVCs
for Status Indians (see sidebar: Aboriginal
Aboriginal Terminology
Aboriginal peoples are the descendants of the original inhabitants of North America. The terminology used to refer
to Aboriginal peoples in Canada has varied over the years. The Constitution Act recognizes three groups of Aboriginal
people: Indian, Inuit, and Mtis.3
The term Indian is still used when referring to legislation or government statistics, although First Nations
has largely replaced Indian as the terminology preferred by many Aboriginal people in Canada. The term Status
Indian refers to those who are entitled to receive the provisions of the Indian Act, while Non-Status Indians are
those who do not meet the criteria for registration or who have chosen not to be registered. First Nations refers to
both Status Indians and Non-Status Indians. First Nations peoples are often members of a First Nations band. The
Inuit are a distinct population of Aboriginal people. They live primarily in Nunavut, the Northwest Territories, and
northern Labrador and Quebec.4 The term Mtis consists of people of mixed First Nations and European ancestry
who identify themselves as Mtis, and are distinct from First Nations peoples (Indians), Inuit, and non-Aboriginal
peoples. Most Mtis live in Alberta, Saskatchewan, or Manitoba.
In January 2013, the Federal Court of Canada ruled that both Mtis and non-Status Indians are considered
Indians under the Constitution Act, which is a new interpretation, and the implications of this ruling have yet to be
determined. The federal government has appealed this decision, and the Supreme Court of Canada has agreed to
hear the case.5
This report uses the term Aboriginal unless describing data pertaining specifically to Status Indians.
Data for this chapter were developed through different processes than the other chapters in this report, and data differ in the
sources and years presented. See Appendix B for more information.
ak
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157
158
9.1
Fraser
Northern
19.4%
24.5%
Island
20.7%
Interior
22.9%
Vancouver
Coastal
12.5%
Note: Aboriginal population includes persons of self-reported Aboriginal identity residing in BC including North American Indians, Mtis, Inuit, Treaty
and Status First Nations. These proportions are additive and include both the on-reserve and off-reserve Aboriginal population.
Source: Statistics Canada, 2006 Census data, provided by BC Stats. Prepared by the Office of the Provincial Health Officer, 2015; and Population Health
Surveillance, Engagement and Operations, Ministry of Health, 2015.
Individuals were identified as North American Indian in accordance with Statistics Canada terminology, but will be discussed
here as First Nations.
al
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
159
Figure
9.2
20
18
16
Per cent
14
12
10
8
6
4
2
0
Percentage of Total
Northern
Interior
Island
Fraser
Vancouver Coastal
16.6
6.3
5.5
2.5
2.3
Health Authority
Note: Aboriginal population includes persons of self-reported Aboriginal Identity residing in BC including North American Indians, Mtis, Inuit, Treaty and
Status First Nations. These proportions are additive and include both the on-reserve and off-reserve Aboriginal population.
Source: First Nations Health Council. Regional Profiles of First Nations Communities According to Current Provincial Health Authority Regions.60 Prepared by the
Office of the Provincial Health Officer, 2015; and Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
am
Inclusion in the term tripartite partners has evolved and expanded over time; at the time of publication, this term includes
a broad range of content experts, partners, and organizations, including the federal and provincial governments, First Nations
Health Authority, BC Association of Aboriginal Friendship Centres, Mtis Nation BC, Aboriginal services providers, and more.
160
Individuals are identified as Status Indian residents in the DAD if they are classified as such in any the following sources:
Health Canadas Status Verification File, Vital Statistics, and the Status Indian entitlement files from the BC Medical Services Plan
database.
ao
Aboriginal identity is determined from the information gathered during a coroners investigation, including information
provided by the next of kin.
an
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161
OCAP Principles
The principles of ownership, control, access, and possession (OCAP), help First Nations communities
and academic institutions establish research partnerships that protect the rights of First Nations peoples.
These principles ensure that the rights of indigenous peoples are protected in research and information
management, as these rights have not always necessarily been protected. OCAP principles honour the goals
of Aboriginal self-determination and self-governance in research and information.
Ownership: The collective ownership, by a community or group, of their cultural knowledge, data, and
information.
Control: The right of First Nations communities to control all aspects of the research process from
planning to management of information.
Access: The right of First Nations communities to have access to all data and information on them
regardless of where it is held. In practice, this can be achieved through standardized protocols.
Possession: The physical control of data, a mechanism by which ownership can be asserted and
protected.
First Nations Centre, Ownership, Control, Access and Possession19 and First Nations Information
Governance Centre, The First Nations Principles of OCAP 20
162
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163
Figure
9.3
50
45
40
35
30
25
20
15
10
5
0
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
34.7
46.8
37.3
34.0
28.5
38.1
24.6
21.2
29.4
26.8
36.1
23.3
18.8
18.8
13.1
12.7
11.4
10.7
10.2
9.9
9.0
9.0
8.8
10.3
9.5
9.5
9.6
7.1
Number of SI Fatalities
39
51
48
43
38
46
35
30
34
32
50
36
30
27
Number of OR Fatalities
440
444
415
398
385
381
353
363
345
422
397
399
415
307
Year
Notes: Age-standardized rates are calculated using Canada 1991 Census population. See Appendix B for more information about this data source.
Source: BC Vital Statistics Agency, data as of January 2, 2008. Prepared by Population Health Surveillance, Engagement and Operations, Ministry of Health, 2015.
164
Figure
9.4
563.0
1,087.4
Cancer
338.2
Suicide
Cause of Death
1,160.8
842.5
827.0
303.8
788.2
143.5
Infectious/Parasitic Diseases
774.9
139.8
Accidental Poisoning
601.4
218.1
533.0
140.7
493.0
68.4
Status Indians
457.3
67.9
Other Residents
387.7
281.3
200
400
600
800
1000
1200
1400
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165
Analysis by Region
Figure
9.5
Age-standardized Hospitalization
Rate per 100,000 Population for Status Indians and
Other Residents, by External Cause, BC, 2004/2005-2006/2007
597.7
Falls
335.8
340.9
237.3
214.7
125.8
206.5
Assault
42.7
Status Indians
172.9
Self-Inflicted
Other Residents
35.6
463.9
236.0
100
200
300
400
500
600
700
166
Figure
9.6
50
45
40
35
30
25
20
15
10
5
0
Interior
Northern
Fraser
Vancouver
Coastal
Island
BC Total
35.9
26.1
20.2
18.6
18.0
24.6
15.7
20.7
8.4
5.2
7.0
9.2
Number of SI Fatalities
50
47
28
21
29
175
Number of OR Fatalities
535
259
602
282
261
1,940
Health Authority
Notes: Age-standardized rates are calculated using Canada 1991 Census population. See Appendix B for more information about this data source.
Source: BC Vital Statistics Agency, data as of January 02, 2008. Prepared by Population Health Surveillance, Engagement and Operations, Ministry of
Health, 2015.
Figure
9.7
1200
1000
800
600
400
200
0
Years of Life Lost
Interior
Fraser
Northern
Island
Vancouver Coastal
1,088
1,002
787
754
597
Health Authority
Note: Potential years of life lost (age under 75 years) rate calculated using Canada 1991 Census population.
Source: Provincial Health Officer. 2009. Pathways to Health and Healing: 2nd Report on the Health and Well-being of Aboriginal People in British Columbia.
Provincial Health Officers Annual Report 2007. Chapter 4 Data File.28 Prepared by Population Health Surveillance, Engagement and Operations, Ministry of
Health, 2015.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
167
9.8
5.6
1.5
Homicide
Cause of Death
Figure
4.5
0.7
1.0
1.0
4.0
4.0
3.4
2.2
2.8
1.7
2.8
2.9
Exposure to Fire/Burns
2.3
0.4
0.9
0.7
Status Indians
Other Residents
2.3
1.7
168
ap
aq
A reserve is land set aside by the federal government for the use and benefit of a First Nation.
In this study, "impaired" is defined as blood-alcohol content (BAC) 0.08 or higher.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
169
Restraint Use
Figure
Percentage of Youth On- and Off-reserve Who Always Wore a Seat Belt
When Riding in a Vehicle, BC, 2003, 2008, and 2013
9.9
Percentage Who Always Wore Seat Belt
80
70
60
50
40
30
20
10
0
2003
2008
2013
On-reserve
35
50
59
Off-reserve
49
63
73
Year
Note: See Appendix B for more information about this data source.
Source: Adolescent Health Survey, McCreary Centre Society, 2003, 2008, 2013. Prepared by Population Health Surveillance, Engagement and Operations,
Ministry of Health, 2015.
ar
The remaining 16 (24.6 per cent) had unknown restraint use. This review had issues with underreported data so caution should
be used when interpreting results.
170
Safe Speeds
Data are somewhat limited in examining
Aboriginal people and speeding behaviours
in BC. Some investigations have compared
on- and off-reserve speeding behaviour
within BC among all residents and found
they are quite similar; for example, according
to ICBC police-reported data for 20032007,
37.5percent of on-reserve MVC-related
fatalities involved speeding, compared to
37.2 per cent of off-reserve MVC fatalities.37
Excessive speed for condition was cited in
44percent of Aboriginal child deaths in 2007
according to the Child Death Review Unit,
BC Coroners Service.41
Safe Roadways
There are several considerations related to
safe roadways that impact MVC rates and
road safety strategies for Aboriginal people
in BC, such as use of rural/remote roads,
reserve roads, and socio-economic factors.
In BC, many First Nations communities
and reserves are located in rural and remote
areas,42 and a considerable proportion of
the Status Indian population in BC live
on reserve.26 As discussed in Chapter7
of this report, rural and remote roads
present numerous challenges related to
road safety, including, but not limited to,
greater response times and farther distances
required to travel for emergency services.43,44
Furthermore, rural living can necessitate
longer travel distances to carry out daily or
weekly activities and involve rougher roads
and terrain41,45all of which expose rural
residents, including Aboriginal people, to
more risk.
Roads leading to and on reserves have
varied governance structures and different
parties are responsible for maintenance
than for other roads in BC.46 Some rural
and remote reserve communities are only
accessible by resource roads (e.g., forestry
roads).17 These communities share resource
as
Safe Vehicles
Despite improvements in many of the
social determinants of health, Aboriginal
people in BC still face lower levels of
educational achievement, higher levels of
unemployment, and are more likely to earn
income under $20,000 per year.1 Lower
socio-economic status negatively influences a
personsability to own a new car or a car with
up-todate safety features and technologies.49
Furthermore, lower socio-economic status
and a lackof vehicle maintenance facilities
in rural and remote areas or on reserves
may also create challenges for properly
maintaining a vehicle.44 The Saskatchewanbased study of Aboriginal people involved in
MVCs found that compared to off-reserve
MVCs, on-reserve MVCs were more likely
to involve a vehicle 20 years old or older.6
Information on the Natural Resource Road Act project can be found at www.for.gov.bc.ca/mof/nrra/.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
171
First Nations communities of Northern BC are spread across a massive geographic area, and
many are only accessible by resource roads, which are poorly maintained and rarely policed. Crashes
involving wildlife are also more common on so-called bush roads. Inadequate vehicle maintenance
is not only related to poverty but to the reality that many smaller, remote communities have no
mechanical services available. Gravel and forest service roads are rough, and increase the likelihood
of mechanical breakdown for all vehicles. It has been noted that on reserve especially, vehicles may
be overloaded, seat belts are not utilized, and children [are] not properly secured in child safety seats.
Access to the nearest town which acts as a service centre to the First Nations community can be a
challenge for many First Nations peoples who dont own a reliable vehicle.
D. Bowering, Crossroads: Report on Motor Vehicle Crashes in Northern BC 44
PREVENTING MVCS IN
ABORIGINAL COMMUNITIES
Interventions designed to improve rates for
Aboriginal populations will need to consider
the inequities in the social determinants
of health, rural and remote factors, as
well as the legacy of colonization. For
example, initiatives designed to promote
community health, emotional well-being,
self-determination, and empowerment have
the potential to result in positive, measurable
effects on many health outcomes, including
reduced injury and death due to MVCs.
The US Centers for Disease Control and
Prevention have an online resource for
promoting road safety among American
Aboriginal peoples (American Indians
172
at
The evaluation criteria were not defined by Aboriginal communities, who may define best practices differently.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
173
174
The Child Passenger Safety Networks goal is to empower Aboriginal communities with tools to ensure all residents are traveling
in vehicles as safely as possible.
av
Partners from the provincial government include representatives from the following organizations: Ministry of Forests, Lands
and Natural Resource Operations; Ministry of Transportation and Infrastructure; and BC Coroners Service.
au
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175
SUMMARY
Aboriginal people experience inequities in
the social determinants of health, which
play a large role in the elevated rates of
motor vehicle crash (MVC) fatalities and
serious injuries among Status Indians and
other Aboriginal peoples in BC. Speed,
substance-based impairment, and not using
restraints, were among the top contributing
factors for MVCs involving Aboriginal
people, which is similar to the situation
for the broader population. For Aboriginal
people living rurally or on rural reserves,
additional contributing factors have
been identified, including longer driving
distances for day-to-day activities, longer
distances from emergency health services,
lack of rural and remote road maintenance,
and, for some, economic and geographic
barriers to acquiring newer vehicles and
maintaining older vehicles. Efforts to
address MVCs among Aboriginal people
176
Chapter 10
177
178
aw
Challenges to data analyses regarding Aboriginal peoples in BC and road safety are described in Chapter 9.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
179
RECOMMENDATIONS
Governance related to road safety and
MVCsis complex, and there has already
been considerable collaboration and work
done in BC and Canada to improve road
safety. International comparisons indicate
that a 50percent reduction in the number
of fatalities and serious injuries resulting
from MVCs in BC is an achievable
intermediate public health goal as we work
toward the British Columbia Road Safety
Strategy: 2015 and Beyond vision of having
the safest roads in North America and
the ultimate goal of zero traffic fatalities
(Vision Zero).1 With new technologies
and innovative infrastructure available,
Vision Zero is an achievable goal, and as
such, pursuit of this goal is a responsibility of
public health and road safety partners.
Based on the framework and data presented
in this report, the Provincial Health Officer
has identified key areas for action to improve
road safety and related public health
outcomes in BC. These recommendations
have four underlying principles:
180
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181
182
Safe Speeds
Speed is the largest contributing factor to
MVC fatalities in BC, and vehicles travelling
at unsafe speeds should be a priority to
focus immediate efforts and resources on, in
order to reduce speed-related fatalities and
serious injuries. These recommendations
highlight the need for an evidence-based,
health and safety-first approach to setting
speed limits that would increase safety for all
road users. Reducing speed-related serious
injuries and fatalities requires collaboration
between the Ministry of Health, Ministry
of Justice, Ministry of Transportation and
Infrastructure, and local governments.
11. Set speed limits throughout the province
based on roadway type, with consideration
of the most vulnerable road users who
frequent each type of roadway and the
associated survivable speed for those road
users during a motor vehicle crash. This
includes monitoring and assessing the
impacts of any increases in speed limits
introduced, in addition to other policy
changes that may result in increased
speed, and appropriate corrective action to
safeguard the health of BC road users.
12. Amend the Motor Vehicle Act to reduce
the default speed limit on roads within
municipalities and treaty lands from
50km/h to a maximum of 30 km/h
(the survivable speed for pedestrians
and cyclists). This approach is consistent
with road use best practices and increases
consistency in speed limits across the
province.
Safe Roadways
There have been many improvements to
roadway infrastructure in BC over the
last few decades; however, further work
is required to improve the health of road
users while meeting the growing demands
of the population, including greater access
to public transit and increased safety and
opportunities for vulnerable road users.
Rural and remote areas face additional
challenges (e.g., longer emergency response
times, less public transit, and more wildlife
interactions) that must be considered
when working to enhance roadways in
BC. Improving the safety of BCs roadways
requires collaboration between many
partners, particularly the Ministry of
Health, Ministry of Justice, Ministry of
Transportation and Infrastructure, and local
governments.
15. Ensure that roadways in BC are
safe for all road users by prioritizing
pedestrian and cyclist health and safety
in road and intersection design. This
includes evaluating and improving
Safe Vehicles
Some motor vehicle crashes in BC are
directly attributable to vehicle design
or condition (e.g., defective tires, brake
failure). Innovations and improvements in
vehicle design and engineering can prevent
motor vehicle crashes from occurring and
prevent fatalities and serious injuries of
road users when they do occur. Improving
road safety through safer vehicles in
BC requires collaboration between the
Insurance Corporation of British Columbia,
the Ministry of Transportation and
Infrastructure, and Transport Canada.
17. Collaborate with car manufacturers
and encourage them to promote safety
features that align with evidence-based
best practices. This should include the
expansion of safety features that come
standard in new vehicles (e.g.,pedestrian
detection), and mechanisms to
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183
184
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
185
Lead Organization
Recommendations
#14
Transport Canada
#17, #19
CONCLUSION
Road safety in BC is a critical public health
issue. There have been many successes in
road safety in BC over the last few decades,
including advancements in vehicle design,
roadway design, and road user behaviour.
Despite the growth in the population and the
associated stress on roadway systems in the
province, the result of these improvements is
that the numbers and rates of motor vehicle
crash (MVC) fatalities and serious injuries
have decreased. However, preventable MVC
fatalities and serious injuries still occur in
BC and the overall decline has not kept pace
with other jurisdictions. In addition, some
populations experience a disproportionate
burden of MVC fatalities and serious
Since this reorganization took place after this report was finalized, it is not reflected in discussions regarding governance over
roads and road safety.
ax
186
Appendix A: Glossary
Appendix A
Glossary
A
Aboriginal people
The descendants of the original inhabitants of North America. The terminology used
to refer to Aboriginal people in Canada has varied over the years. The Constitution Act
recognizes three groups of Aboriginal people: Indian, Inuit, and Mtis. See also: First
Nations, Inuit, Mtis, and Status Indians; and sidebar Aboriginal Terminology in Chapter 9.
Active transportation
All human-powered forms of travel, such as walking, cycling, using a wheelchair, inline
skating, skateboarding, skiing, canoeing, etc.1 Walking and cycling are most popular and
can be combined with other modes of travel, such as public transit.2
Adaptive headlights
A vehicle technology that points the vehicles headlights in the direction the vehicle is
going rather than straight ahead. This helps a driver see around curves in the dark.5
These air bags provide similar protection for the driver and front passenger as regular
air bags but use a dual inflation system that deploys the air bags at varying pressure
levels depending on the severity of the crash, the size of the occupant, and how close the
occupant is to the air bag.3 See also: air bag.
Age-standardized rate
The summary of age-adjusted death rates by age and sex, which have been standardized
to a 1991 Canada Census standard population for the purpose of rate comparisons
between sexes, different time periods, or different geographic locations. The agestandardized fatality rate per 100,000 population is the theoretical number of deaths
that would occur per 100,000 population if the specific population had the same age
structure as the standard population.
Air bag
A vehicle safety device designed to inflate instantly in a motor vehicle crash to protect
the vehicle occupants6and in some cases vulnerable road users outside of the vehicle
from injury or death by cushioning them from hard vehicle surfaces. They are designed
to supplement seat belts. See also: advanced front air bags.
Alcohol impairment
In BC, a driver is considered impaired by alcohol when they have a blood alcohol
content (BAC) level of 50 milligrams of alcohol per 100 millilitres of blood.7 In Canada,
it is a criminal offence to operate a motor vehicle with a BAC of 80 milligrams of alcohol
per 100 millilitres of blood or higher.8 See also: blood alcohol content, impairment.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
187
Appendix A: Glossary
Anti-lock braking
systems
Brake assist
Bull bars
Rigid metal bars affixed to the front of a vehicle (often a sport-utility vehicle or truck),
usually as an after-market modification to protect the vehicle in case of collision,
especially with a wild animal.12
Cognitive impairment
The reduced ability to operate a vehicle due to inadequate mental function. This could
result from a variety of conditions such as age, illness, fatigue, and/or disability. See
also:impairment.
Commercial drivers
People who drive as part of their core business activity and often receive related special
training.13 Examples of commercial drivers include bus drivers, taxi drivers, couriers,
emergency vehicle drivers, and drivers of heavy commercial vehicles.14 Commercial
drivers are different than occupational drivers. See also: occupational drivers.
Commercial vehicles
A commercial vehicle can be any vehicle registered with a business and used to transport
goods and/or passengers. Examples of commercial vehicles include trucks, taxis, buses,
ambulances, and dump trucks.14
Contributing factors
The events and circumstances that are perceived to have contributed to a motor vehicle
crash (MVC). In this report, these are factors that an attending police officer records in
an accident report after an MVC,15,16 and they fall within four broad categories:
(1) human conditions, e.g., distraction of a driver or other road user, driver inattention,
driver impairment; (2) human actions, e.g., driver error, speeding, failing to yield right of
way; (3) environmental conditions, e.g., road conditions, weather, wild animals; and
(4) vehicle condition, e.g., defective tires, defective brakes.15,16
Crash avoidance
technologies
A vehicle system that warns a driver and/or intervenes in driving to avoid or reduce the
severity of an impending motor vehicle crash. They range from assisting drivers to stay
alert to their surroundings to assuming control of the vehicle to prevent a crash if a driver
is not responding appropriately (e.g., auto-braking, auto-steering).17 Crash avoidance
technologies are also known as collision avoidance systems and active safety systems.
188
Appendix A: Glossary
Crashworthiness
Cruise control
A vehicle technology that maintains a consistent speed without using the gas pedal.19 See
also: adaptive cruise control.
Vehicle headlights that come on automatically when the engine is started. Their purpose
is to increase the vehicles visibility to oncoming traffic during daylight hours.20 All new
vehicles imported into or sold in Canada after December 1, 1989, must have daytime
running lights.21
Distracted driving
Distraction
Drug impairment
The reduced ability to operate a vehicle due to the consumption of legal drugs (such as
medications) and illegal or illicit drugs. See also: impairment.
Electronic stability
control
A vehicle technology that helps a driver maintain control by preventing skidding under
most driving conditions, including on icy, slushy, and snowy roads.25 Electronic stability
control (ESC) monitors the drivers use of the brake pedal, and when the steering
direction does not match vehicle direction, ESC applies brakes to one or more wheels
and/or reduces engine power to regain control.26 In 2011, ESC became mandatory for all
new vehicles sold in Canada.26
Environmental streets
Roadways that use a variety of built elements, usually aesthetically rendered, to calm and
slow traffic, and encourage driver attention (e.g., planter boxes, pedestrian refuges on
road crossings, raised pedestrian crosswalks).27
First Nations
A collective term used to identify Aboriginal people who are often members of a First
Nation band or tribe. First Nations refers to both Status Indians and Non-Status Indians.
The term First Nations has largely replaced the term Indian as the terminology preferred
by many Aboriginal people in Canada; however, Indian is still used when referring to
legislation or government statistics. See also: Aboriginal people, Non-Status Indians, Status
Indians.
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189
Appendix A: Glossary
Forward collision
warning systems
Heavy vehicle
The largest vehicle weight/size class, but the weight/size varies by source (as noted in
related discussions in this report). Heavy vehicles include both straight trucks (engine
unit and flatbed that cannot be detached), tractors (a cab accompanied by a detachable
trailer),30 and in some cases includes public buses.15 These vehicles are generally used for
commercial purposes. See also: light vehicle, medium vehicle.
High-risk driver
Drivers who drive in an aggressive manner or in a way that may harm property or
another person and who may display risk-taking behaviour or hostile behaviour toward
another individual.31 They can also be identified as drivers with high numbers of driving
violations compared to average drivers.32
Highway
Major roadways that are designed for large volumes of traffic (including commercial
transport vehicles) moving intra-provincially, inter-provincially, and/or internationally.
Larger highways are often called freeways or expressways, and speed limits are typically
higher than on local roads.33
Ignition interlock
Immediate Roadside
Prohibitions
Impairment
The reduced ability to operate a vehicle due to one or more causes, including consuming
alcohol, consuming drugs (legal, illegal or illicit), inadequate cognitive function, or
inadequate physical function. See also: alcohol impairment, cognitive impairment, drug
impairment, and physical impairment.
Intelligent speed
adaptation
A vehicle technology that detects when a driver is travelling over the posted speed limit
based on electrical signals from a beacon/transmitter attached to roadside infrastructure
or via global positioning system (GPS) technology.36 It either audibly or visually warns
the driver they are speeding or assumes control of limiting the speed of the vehicle to
prevent speeding.
Intersection
An area where two or more roads cross each other.37 In this report it is categorized as a
roadway type.
190
Appendix A: Glossary
Inuit
A vehicle technology that monitors the area immediately around and behind a vehicle to
assist a driver when changing lanes. If the system detects a vehicle in the adjacent lane, it
alerts the driver to the presence of the other vehicle.38
Lane departure
warning systems
A vehicle technology that monitors the position of a vehicle relative to the lane
boundary.38 The system delivers a warning to the driver if the vehicle appears to be
drifting or departing from its lane (e.g., due to driver inattention),38,39 so that the driver
can correct the vehicles course,40 and thus prevent lane departure crashes.
A type of lane departure warning system that helps a driver by controlling the vehicle to
ensure it stays within its lane.40 See also: lane departure warning systems.
Leading pedestrian
intervals
Signal timing that allows pedestrians to begin crossing the street before vehicles (usually
by 3-7 seconds), with the purpose of increasing pedestrian visibility and thus reducing
pedestrian motor vehicle crashes.41
Light vehicle
The smallest vehicle weight/size class, but the weight/size varies by source (as noted in
related discussions in this report). Light vehicles generally include cars, station wagons,
vans, sport-utility vehicles, and small pickup trucks.30 These vehicles may be used for
personal or commercial purposes. See also: heavy vehicle, medium vehicle.
Local roads
These roads are the lowest functional road class,42 and are usually used by light vehicles,
cyclists, and pedestrians. Definitions of local roads vary; for example, roads giving access
to individual land use such as residences42 or roads without a centre line.43 See also: major
roads.
M
Major roads
These are roads with a higher functional road class than local roads, and a lower class
than highways. They are usually the roads that connect activity centres, residential areas,
and service areas.42 See also: local roads.
Medium vehicle
The mid-sized vehicle weight/size class, but the weight/size varies by source (as noted
in related discussions in this report). Medium vehicles are usually straight trucks (an
engine unit and flatbed that cannot be detached)30 but can also include sport-utility
vehicles, pickup trucks, and vans. These vehicles may be used for personal or commercial
purposes. See also: light vehicle, heavy vehicle.
Mtis
A distinct people of mixed First Nation and European ancestry who identify themselves
as Mtis, and are distinct from Status Indians, Inuit, and non-Aboriginal people. Most
Mtis live in Alberta, Saskatchewan, or Manitoba. See also: Aboriginal people.
Motorcycle
A motor vehicle that runs on two or three wheels, and has a saddle or seat for the driver
to sit on.44
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
191
Appendix A: Glossary
N
Non-Status Indians
People who identify as First Nations but either do not meet the criteria for registration
as a Status Indian under the Indian Act or who have chosen not to be registered. See
also:Aboriginal people, Status Indians.
Occupational drivers
Drivers who are required to drive for work-related purposes, but driving is not their
principal occupation. They are not necessarily professional drivers, and they have
generally not received related specialized training or testing. Examples of occupational
drivers include community health professionals, and workers in retail, wholesale, and
service industries.13 Occupational drivers are different than commercial drivers. See
also:commercial drivers.
Designated cycling lanes located directly adjacent to a motor vehicle roadway and
indicated with painted lines.46,47 See also: protected cycling paths.
Pedestrian
Pedestrian scramble
Pedestrian streets
Roads strictly for pedestrian use (i.e. closed to vehicles), and usually located in a busy
commercial area.49
Physical impairment
The reduced ability to operate a vehicle due to physical functioning. This could result
from a variety of conditions such as age, illness, and/or disability. See also: impairment.
Designated paths for cyclists that are protected from motor vehicle traffic by a buffer
space or physical barrier, such as curbs or bollards (short posts that divide traffic).46,47
See also: painted cycling lanes.
Cameras affixed to traffic lights that automatically photograph vehicles that travel
through an intersection when the light is red, in order to issue a violation ticket.50
Reserve
Refers to a First Nations reserve, which is a piece of land owned by the Government
of Canada and set aside for use by a First Nations band.45 People, services, objects, or
events, such as motor vehicle crashes, occurring within this land are recognized as onreserve.
192
Appendix A: Glossary
Resource roads
One or two lane, gravel roads in remote areas built for commercial access to natural
resources such as forests, petroleum, and minerals. They also include Land Act roads and
special-use permit roads.51
Road
In this report, road and roadway are used interchangeably and generally mean the open
way for vehicles and persons. A road may include only the strip used for travel (usually
paved or gravel) or may encompass related features on the right-of-way such as the
shoulder or sidewalk. See also: highway, local roads, resource roads, rural roads.
Road rage
An extreme form of driver aggression and high-risk driver behaviour that typically results
from high levels of driver frustration, stress, anger, and hostility.52,53 It is an overreaction
of aggressive thoughts, behaviours, and emotions of a driver targeted at a victim in
response to a road-related incident.54
Road user
Anyone using a roadway. This includes but is not limited to pedestrians, cyclists,
motorcyclists, vehicle drivers, and bus occupants.55
When a road users attention is diverted to an object, activity, event, or person not
related to the road. It can include a wide range of activities, such as eating and drinking,
smoking, personal grooming, interacting with other people, using a navigation system,
and any use of cellular phones (both handheld and hands-free) or other electronic
devices.22,23 See also: distracted driving.
Roadway
See road.
Roadway departure
The act of driving off the portion of the road intended for motor vehicles, usually
unintentionally.56
Roundabouts
Circular intersections that do not have electronic signals or stop signs,57 in which traffic
flows around a center traffic island.49
Rural roads
An approach to understanding road safety that is guided by the concepts that road
systems should be designed to accommodate inevitable human error and should
account for the limitations of the human body to withstand physical force, and that the
responsibility for road safety is shared across the system by users, designers, and policy
makers.59 There are some variations of this approach, but the four main pillars examined
in this report are safe vehicles, safe speeds, safe roads, and safe road users.
Sobriety checkpoints
Speed camera
A device that uses laser and radar technology to detect when a vehicle is speeding and
takes a photograph of the speeding vehicle in order to issue a penalty to the vehicle
owner.61
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
193
Appendix A: Glossary
Speed hump
Speed limiters
Devices installed in a vehicles engine to prevent excessive speed.63 They are most
commonly used in heavy commercial vehicles.
Speeding
Speeding in BC includes driving faster than the designated speed limit and driving too
fast for the conditions (which may be lower than a posted limit). Excessive speeding is
when an individual drives at a speed more than 40 km/h over the speed limit.60
Status Indians
People who identify as First Nations and who are entitled to receive the provisions of and
have registered under the Indian Act.64 See also: Aboriginal people, Non-Status Indians.
Survivable speed
The maximum vehicle travelling speed at which the human body is likely to survive
impact from a motor vehicle crash if it should occur. Vulnerable road users have lower
survivable speeds than vehicle occupants.32,65
Traffic calming
The modification of a roadway and its design in a way that is intended to improve road
safety, especially for vulnerable road users, by reducing and slowing the flow of traffic in
the area. Safety is increased by implementing changes that aim to minimize the negative
impacts of vehicle use, reduce traffic volume, change drivers behaviours, lower speeds,
and reduce conflict between road users with improved conditions for pedestrians and
cyclists.66 Examples of traffic calming modifications include changes to the road layout,
creation of one-way streets, addition of roundabouts, addition of speed bumps, and more.67
Underride guards
Steel bars extending downward from the back or sides of large trucks to prevent smaller
vehicles from moving underneath the trucks trailer in a motor vehicle crash.68
Residential roads designed for non-vehicle road use, including play, rather than vehicles,
and where only residential vehicles are allowed.49
Vehicle crash
incompatibility
The mismatch of vehicle designs (shapes, sizes, and conditions), which makes safety
features less likely to function optimally during a motor vehicle crash (MVC), thereby
resulting in a greater likelihood of serious injury or fatality to some vehicle occupants in
the event of an MVC (usually the smaller vehicles occupants).69
194
Appendix A: Glossary
Vehicle kilometres
Any road user who does not have the protection of an enclosed vehicle, and is therefore
at heightened risk of injury or fatality related to a motor vehicle crash.71 This generally
includes pedestrians, cyclists, and motorcyclists.72
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
195
Appendix A: Glossary
196
Appendix B
DATA SOURCES
BC Vital Statistics
The BC Vital Statistics Agency registers
events such as births, deaths, and marriages
in BC and provides a range of vital
statistics-related products and services to
meet public needs. Data entered into the
mortality database consist of injury event
classifications, region of residence, unique
identifiers, place of injury occurrence, nature
and cause of injury, anatomical location,
pre-event circumstances, manner of death,
and toxicology reports. BC Vital Statistics
uses the World Health Organizations
International Statistical Classification
of Diseases (ICD) codes (Version 10) to
present data, including death data. MVCs
are associated with the following codes:
V02-V04, V09, V12-V14, V190-V196,
V20-V79, V803-V805, V820-V821,
V823-V890, V899, Y850.
BC Vital Statistics data regarding MVC
fatalities were used in this report in
197
198
199
200
WorkSafe BC MVC-related
Insurance Claim Data
WorkSafe BC is responsible for
educating employers and workers about
the Occupational Health and Safety
Regulation1 (a regulation under the Workers
Compensation Act) and for monitoring their
compliance with the regulation. WorkSafe
BC also works with employees and their
employers to provide return-to-work
rehabilitation, financial compensation,
health care benefits, and a range of other
services when they experience work-related
injury or disease. For this report, WorkSafe
BC provided data on the number of MVCrelated insurance claims and the costs of
the claims paid by WorkSafe BC. They also
provided information about the age and sex
of the claimants.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
201
202
References
References
Chapter 1
1.
11.
12.
13.
2.
14.
3.
15.
4.
16.
17.
5.
18.
6.
19.
20.
21.
22.
23.
7.
8.
9.
10.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
203
References
24.
25.
Provincial Health Services Authority. Health 201 A knowledgeto-action framework for creating healthier built environments.
Vancouver, BC: Provincial Health Services Authority; 2010 Mar
[cited 2015Jan28]. Available from: http://www.phsa.ca/Documents/
health201_knowledgetoactionframework_final.pdf.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
204
39.
40.
41.
42.
43.
44.
45.
International Traffic Safety Data and Analysis Group. Road safety annual
report 2014: summary. Paris: International Transport Forum; 2014.
46.
47.
48.
49.
50.
51.
52.
53.
References
Chapter 2
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Sansone RA, Sansone LA. Road rage: whats driving it? Psychiatry
(Edgmont). 2010 July;7(7):14-18.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
Gleave SD. What light rail can do for cities: a review of the evidence.
UK Passenger Transport Executive Committee; 2005. Cited by Litman
T. Rail transit in America: a comprehensive evaluation of benefits.
Victoria, BC: Victoria Transportation Policy Institute; 2012 Jan 16
[cited 2015 Oct 5]. Available from: http://www.vtpi.org/railben.pdf.
29.
30.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
205
References
31.
32.
33.
Chapter 3
1.
2.
3.
4.
5.
6.
7.
8.
Green H. Who drives the car him or her? [Internet]. The Guardian;
2013 Nov 22 [cited 2015 Jan 30]. Available from: http://www.
theguardian.com/lifeandstyle/2013/nov/22/who-drives-car-him-or-her.
9.
10.
11.
206
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
WorkSafe BC. Operational data warehouse. 2013 MVI claim stats for
road safety initiatives, Vancouver, BC: WorkSafe BC; 2014 Dec.
References
30.
46.
31.
BC Ministry of Justice. Seat belts, car seats and booster seats [Internet];
[cited 2013 Dec 13]. Available from: http://www.pssg.gov.bc.ca/osmv/
road-safety/seatbelts.htm.
47.
32.
48.
49.
Shope JT, Molnar LJ. Graduated driver licensing in the United States:
evaluation results from the early programs. J Safety Res. 2003;63-9.
50.
51.
35.
52.
36.
37.
53.
54.
38.
Cummins JS, Koval KJ, Cantu RV, Spratt KE. Do seat belts and air
bags reduce mortality and injury severity after car accidents? Am J
Orthop. 2011 Mar;40(3):E26-9.
55.
39.
40.
56.
41.
57.
Williams AF, Ferguson SA. Rationale for graduated licensing and the
risks it should address. Inj Prev. 2002;8(2S):ii9-ii16.
58.
59.
60.
61.
62.
Wiggins S. Graduated licensing program: interim evaluation report year 3. North Vancouver, BC: ICBC Performance Analysis Services;
2004. Available from: http://www.icbc.com/driver-licensing/Gettinglicensed/glp-report.pdf.
33.
34.
42.
43.
44.
45.
Transport Canada. Rural and urban surveys of seat belt use in Canada
2009-2010 [Fact Sheet TP 2436E,RS-2011-01]. Ottawa, ON:
Transport Canada; 2011 Jan [cited 2015 Jan 30]. Available from:
http://www.tc.gc.ca/media/documents/roadsafety/tp2436e-rs201101.pdf.
Olsen CS, Cook LJ, Keenan HT, Olson LM. Driver seat belt use
indicates decreased risk for child passengers in a motor vehicle crash.
Accid Anal Prev. 2010;42:771-7.
Wilson RJ, Wiggins S, Fang M. A community initiative to
increase use of seat belts in Northern British Columbia: impacts
on casualty crashes. Traffic Inj Prev. 2010 Jun;11(3):249-57. doi:
10.1080/15389581003614896.
Solomon MG, Preusser DF, Tison J, Chaudhary NK. Evaluation
of the May 2007 Click It or Ticket mobilization. Washington,
DC: National Highway Traffic Safety Administration;
2009 Dec [cited 2015 Jan 30]. Available from: http://
www.nhtsa.gov/Driving+Safety/Research+&+Evaluation/
Click+It+or+Ticket+Seat+Belt+Mobilization+Evaluation+Reports.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
207
References
63.
64.
65.
66.
Chapter 4
1.
2.
3.
4.
5.
6.
7.
Beck L, Dellinger AM, ONeil ME. Motor vehicle crash injury rates
by mode of travel, United States: using exposure-based methods to
quantify differences. Am J Epidemiol. 2007;166(2):212-18. doi:
10.1093/aje/kwm064 2007.
8.
9.
67.
68.
69.
70.
71.
Road Safety at Work. Who we are [Internet]; [cited 2015 Jan 28].
Available from: http://roadsafetyatwork.ca/who-we-are/overview/.
72.
73.
74.
10.
75.
11.
12.
76.
Beck L, Dellinger AM, ONeil ME. Motor vehicle crash injury rates
by mode of travel, United States: using exposure-based methods to
quantify differences. Am J Epidemiol. 2007;166(2):212-18. doi:
10.1093/aje/kwm064 2007.
77.
13.
78.
14.
15.
79.
208
References
16.
Lin MR, Kraus JF. A review of risk factors and patterns of motorcycle
injuries. Accid Anal Prev. 2009 Jul;41(4):710-22.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Motor Vehicle Act [RSBC 1996, Chapter 318, Section 183] [statute on
the Internet]; [cited 2015 Jan 28]. Available from: http://www.bclaws.
ca/Recon/document/ID/freeside/96318_05.
Statistics Canada. Proportion of workers commuting to work by
car, truck or van, by public transit, on foot, or by bicycle, census
metropolitan areas, 2011 (table). National Household Survey;
[modified 2013 May 24; cited 2015 Jan 28]. Available from:
http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-012-x/2011003/
tbl/tbl1a-eng.cfm.
BC Ministry of Transportation and Infrastructure. Bike BC: cycling
policy [Internet]. Victoria, BC: BC Ministry of Transportation and
Infrastructure; [cited 2014 Jan 8]. Available from: http://www.th.gov.
bc.ca/BikeBC/policy.html.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
209
References
47.
61.
48.
62.
49.
Motor Vehicle Act [RSBC 1996, Chapter 318, Section 184] [statute on
the Internet]; [cited 2015 Jan 28]. Available from: http://www.bclaws.
ca/Recon/document/ID/freeside/96318_05.
63.
50.
64.
51.
65.
52.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
53.
54.
55.
56.
57.
58.
59.
60.
210
References
Chapter 5
1.
2.
3.
4.
5.
6.
7.
Strayer DL, Drews FA, Crouch DJ. A comparison of the cell phone
driver and the drunk driver. Hum Factors. 2006;48:381-91.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
211
References
30.
45.
31.
46.
47.
Keall MD, Frith W, Patterson TL. The influence of alcohol, age and
number of passengers on the night-time risk of driver fatal injury in
New Zealand. Accid Anal Prev. 2004;36:49-61.
48.
49.
50.
32.
33.
34.
35.
51.
36.
52.
37.
53.
54.
38.
39.
40.
Fisher B, Imtiaz S, Rudzinski K, Rehm J. Crude estimates of cannabisattributable mortality and morbidity in Canada implications for
public health focused intervention priorities. J Public Health (Oxf ).
2015 Jan 28:pii. doi: 10.1093/pubmed/fdv005.
55.
Beasley EE, Beirness DJ. Alcohol & drug use among drivers
following the introduction of immediate roadside prohibitions in
British Columbia: Findings of the 2012 Roadside Survey. Ottawa,
ON: Canadian Centre on Substance Abuse; 2012.
41.
56.
Beirness DJ, Beasley EE. Alcohol & drug use among drivers, British
Columbia Roadside Survey 2010. Ottawa, ON: Canadian Centre on
Substance Abuse; 2011.
42.
57.
43.
58.
59.
60.
44.
212
References
61.
78.
62.
79.
63.
Elder RW, Shults RA, Sleet DA, Nichols JL, Thompson RS, Rajab W.
et al. Effectiveness of mass media campaigns for reducing drinking and
driving and alcohol-involved crashes: a systematic review. Am J Prev
Med. 2004;27(1):57-65.
80.
64.
81.
82.
83.
65.
66.
84.
67.
Shults RA, Elder RW, Sleet DA, Nichols JL, Alao MO, Carande-Kulis
VG, et al. Reviews of evidence regarding interventions to reduce
alcohol-impaired driving. Am J Prev Med. 2001;21(4 Suppl):66-88.
85.
68.
Fell JC, Voas RB. The effectiveness of reducing illegal blood alcohol
concentration (BAC) limits for driving: evidence for lowering the limit
to .05 BAC. J Safety Res. 2006;37(3):233-43.
86.
87.
88.
69.
70.
71.
72.
Voas RB, Tippetts AS, Fell JC. Assessing the effectiveness of minimum
legal drinking age and zero tolerance laws in the United States.
Accident Anal Prev. 2003;35(4):579-87.
73.
89.
Elder RW, Schults RA, Sleet DA, Nichols JL, Zaza S, Thompson RS.
Effectiveness of sobriety checkpoints for reducing alcohol-involved
crashes. Traffic Inj Prev. 2002;3:266-74.
74.
90.
75.
91.
76.
92.
93.
Transport for New South Wales, Centre for Road Safety. Random
breath testing [Internet]. Australia: Transport for New South
Wales; [updated 2014 Jul 14; cited 2015 Jul 7]. Available from:
http://roadsafety.transport.nsw.gov.au/stayingsafe/alcoholdrugs/
drinkdriving/rbt/index.html.
77.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
213
References
94.
95.
96.
97.
98.
110.
111.
112.
113.
114.
115.
99.
100.
116.
117.
Canada Safety Council. Drugs and the older driver [Internet]. Ottawa,
ON: Canada Safety Council; [cited 2013 Dec 17]. Available from:
https://canadasafetycouncil.org/senior-safety/drugs-and-older-driver.
101.
118.
102.
119.
103.
120.
121.
122.
123.
124.
125.
104.
McCartt AT, Geary LL, Nissen WJ. Observational study of the extent
of driving while suspended for alcohol-impaired driving [DOT HS 809
491]. Washington, DC: US Department of Transportation, National
Highway Traffc Safety Administration; 2002.
105.
Tashima HN, Helander CJ. 1999 annual report of the California DUI
Management Information System [CAL-DMV-RSS-99-179].
Sacramento, CA: California Department of Motor Vehicles, Research
and Development Section; 1999.
106.
Simpson HM. Who is the persistent drinking driver? Part II: Canada
and elsewhere. Transp Res Circ 1995;437:21-35.
107.
108.
109.
214
References
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
138.
139.
140.
141.
142.
143.
144.
Motor Vehicle Act [RSBC 1996, c.318, s.230] [statute on the Internet];
[cited 2015 Oct 8]. Available from: http://www.bclaws.ca/civix/
document/id/complete/statreg/96318_07#section230.
145.
146.
147.
148.
149.
150.
151.
152.
153.
154.
Sansone RA, Sansone LA. Road rage: whats driving it? Psychiatry
(Edgmont). 2010 July;7(7):14-8.
155.
156.
157.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
215
References
158.
Smart RG, Mann RE. Deaths and injuries from road rage: cases in
Canadian newspapers. CMAJ. 2002 Oct 1;167(7):761-2.
159.
160.
161.
Chapter 6
1.
2.
3.
Motor Vehicle Act [RSBC 1996, c.318] [statute on the Internet]; [cited
2015 Oct 6]. Available from: http://www.bclaws.ca/civix/document/id/
complete/statreg/96318_05.
4.
5.
6.
7.
8.
9.
10.
216
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Data are from the Police Traffic Accident System, Business Information
Warehouse, Insurance Corporation of British Columbia.
21.
22.
23.
Nilsson G. Traffic safety dimension and the power model to describe the
effect of speed on safety. Sweden: Lund Institute of Technology; 2004.
24.
25.
26.
27.
References
28.
29.
30.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
31.
32.
33.
Friedman LS, Barach P, Richter ED. Raised speed limits, case fatality
and road deaths: a six year followup using ARIMA models. Inj Prev.
2007 Jun;13(3):156-61. Available from: http://www.ncbi.nlm.nih.gov/
pmc/articles/PMC2598360/.
34.
35.
36.
37.
38.
54.
55.
56.
39.
40.
41.
57.
42.
58.
43.
59.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
217
References
60.
61.
62.
63.
Chapter 7
12.
13.
14.
Freund PES, Martin GT. Risky vehicles, risky agents: mobility and
the politics of space, movement and consciousness. Cited by Rothe
JP, editor. Driving lessons: exploring systems that make traffic safer.
Edmonton, AB: University of Alberta Press; 2002.
15.
1.
2.
16.
3.
17.
18.
19.
20.
4.
5.
6.
21.
22.
Advocates for Highway and Auto Safety. Intersection safety fact sheet
[Internet]. Washington, DC: Advocates for Highway and Auto Safety;
2011 [cited 2015 Jan 28]. Available from: http://www.saferoads.org/
intersection-safety.
23.
24.
25.
26.
7.
8.
9.
10.
11.
218
References
27.
28.
29.
44.
45.
46.
47.
48.
30.
31.
Bell N, Simons RK, Lakha N, Hameed SM. Are we failing our rural
communities? Motor vehicle injury in British Columbia, Canada,
2001-2007. 2012 Nov;43(11):1888-91.
32.
49.
33.
Data are from the Policy Traffic Accident System, Business Information
Warehouse, Insurance Corporation of British Columbia.
50.
34.
51.
35.
52.
36.
53.
37.
54.
55.
56.
57.
58.
59.
60.
61.
62.
38.
Rea RV, Rea Sr RV. Of moose and mud. Public Roads. 2005 Sep/Oct;
69(2). Available from: http://www.fhwa.dot.gov/publications/
publicroads/05sep/05.cfm.
39.
40.
41.
42.
43.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
219
References
78.
79.
65.
80.
66.
81.
82.
83.
84.
63.
64.
67.
68.
69.
85.
70.
86.
71.
87.
88.
89.
90.
91.
92.
93.
72.
73.
74.
75.
76.
77.
220
References
94.
95.
96.
97.
98.
99.
100.
101.
102.
103.
104.
105.
106.
107.
108.
Chapter 8
1.
2.
3.
4.
5.
6.
7.
8.
Motor Vehicle Safety Act [1993, c.16] [statute on the Internet]; [cited
2015 Jan 28]. Available from: http://www.tc.gc.ca/eng/actsregulations/acts-1993c16.htm.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
221
References
18.
19.
20.
21.
22.
23.
24.
35.
36.
37.
38.
39.
Kelley Blue Book. New KBB study: fuel efficiency and safety
top buyer-priorities list [Internet]. Irvine, CA: Kelley Blue Book;
2011Sep12 [cited 2014 Jan 20]. Available from: http://www.kbb.
com/car-news/all-the-latest/new-kbb-study-fuel-efficiency-and-safetytop-buyer_priorities-list/2000007162/#.
40.
41.
42.
43.
25.
26.
27.
44.
28.
45.
Krajicek ME, Schears RM. Daytime running lights in the USA: what is
the impact on vehicle crashes in Minnesota? Int J Emerg Med.
2010;26;3(1):39-43.
46.
47.
48.
49.
50.
29.
30.
Fiat Canada. 500 c [Internet]; [cited 2015 Aug 21]. Available from:
http://www.fiatcanada.com/en/2015/500c.
31.
Mini Cooper Canada. Home [Internet]; [cited 2015 Aug 21]. Available
from: http://www.mini.ca/.
32.
Nissan Canada. 2015 Nissan Micra [Internet]; [cited 2015 Aug 21].
Available from: http://www.nissan.ca/en/cars/micra.
33.
Honda Canada. Fit [Internet]; [cited 2015 Aug 21]. Available from:
http://www.honda.ca/fit.
34.
Smart Canada. Home [Internet]; [cited 2015 Aug 21]. Available from:
http://www.thesmart.ca/ca/en/index.html.
222
References
51.
52.
53.
54.
55.
56.
57.
Lee JD, McGehee DV, Brown TL, Reyes ML. Collision warning
timing, driver distraction, and driver response to imminent rearend collisions in a high-fidelity driving simulator. Hum Factors.
2002;44(2):314-34.
58.
59.
60.
61.
67.
68.
69.
70.
71.
72.
73.
Du Bois P, Chou CC, Fileta BB, Khalil TB, King AI, Mahmood HF, et
al. Vehicle crashworthiness and occupant protection. Michigan:
American Iron and Steel Institute; 2004 [cited 2015 Jan 28]. Available
from: http://www.autosteel.org/~/media/Files/Autosteel/Research/
Safety/safety_book.pdf.
74.
75.
Crandall JR, Bhalla KS, Madeley NJ. Designing road vehicles for
pedestrian protection. BMJ. 2002;11;324(7346):1145-8.
76.
77.
Cummins JS, Koval KJ, Cantu RV, Spratt KE. Do seat belts and air
bags reduce mortality and injury severity after car accidents? Am J
Orthop. 2011 Mar;40(3):E26-9.
78.
62.
63.
79.
64.
80.
Brumbelow ML, Baker BC, Nolan JM. Effects of seat belt load limiters
on driver fatalities in frontal crashes of passenger cars [Paper number
7-0067]. Arlington, VA: Insurance Institute for Highway Safety;
[cited 2015 Jan 28]. Available from: http://www-nrd.nhtsa.dot.gov/
pdf/esv/esv20/07-0067-W.pdf.
65.
Transport Canada. What you should know about ... anti-lock braking
system: ABS ... what is it? [Internet]. Ottawa, ON: Transport Canada;
[modified 2013 Dec 10; cited 2015 Jan 28]. Available from: https://
www.tc.gc.ca/eng/motorvehiclesafety/tp-tp13082-abs1_e-214.
htm#What.
81.
82.
83.
66.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
223
References
84.
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
111.
112.
Motor Vehicle Act Regulations [B.C. Reg. 26/58; Division 24: Vehicles
of Unusual Size] [statute on the Internet]; [cited 2014Jan30].
Available from: http://www.bclaws.ca/EPLibraries/bclaws_new/
document/ID/freeside/26_58_07.
113.
114.
115.
85.
86.
87.
88.
89.
90.
Braver ER, Ferguson SA, Greene MA, Lund AK. Reductions in deaths
in frontal crashes among right front passengers in vehicles equipped
with passenger air bags. JAMA. 1997;278(17):1437-9.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
224
References
116.
117.
118.
119.
120.
121.
Chapter 9
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
225
References
25.
26.
27.
28.
29.
30.
31.
32.
33.
Sansone RA, Sansone LA. Road rage: whats driving it? Psychiatry
(Edgmont). 2010 July;7(7):14-18.
34.
35.
36.
37.
38.
39.
40.
226
41.
Office of the Chief Coroner, Child Death Review Unit. Office of the
Chief Coroner 2007 annual report. Victoria, BC: Office of the Chief
Coroner; 2007 [cited 2015 Aug 18]. Available from: http://www.pssg.
gov.bc.ca/coroners/shareddocs/cdru-2007annualreport.pdf.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
References
55.
Interim First Nations Health Authority. First Nations child seat share
cooperative. West Vancouver, BC: Interim First Nations Health
Authority; 2012 Jul 11 [cited 2015 Jul 15]. Available from: http://
www.fnhc.ca/pdf/FN_CSSC.pdf.
2.
56.
3.
57.
4.
58.
59.
Arcand, M. First Nations and Roads Summit. First Nations and Roads
Summit Proceedings; 2006 Oct 12-13; Prince George, BC. Nanaimo:
BC Forest Safety Council; 2006 [cited 2013 June 12]. Available from:
http://www.bcforestsafe.org/files/files/newsroom/trucksafe-06-11-02first_nations.pdf.
5.
6.
7.
8.
9.
10.
Transport Canada. What you should know about ... anti-lock braking
system: ABS ... what is it? [Internet]. Ottawa, ON: Transport Canada;
[modified 2013 Dec 10; cited 2015 Jan 28]. Available from: https://
www.tc.gc.ca/eng/motorvehiclesafety/tp-tp13082-abs1_e-214.
htm#What.
11.
12.
13.
14.
15.
Appendix A
16.
1.
17.
60.
Chapter 10
1.
2.
3.
4.
5.
6.
7.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
227
References
18.
Du Bois P, Chou CC, Fileta BB, Khalil TB, King AI, Mahmood HF,
et al. Vehicle crashworthiness and occupant protection. Michigan:
American Iron and Steel Institute; 2004 [cited 2015 Jan 28].
Available from: http://www.autosteel.org/~/media/Files/Autosteel/
Research/Safety/safety_book.pdf.
19.
20.
21.
22.
23.
Strayer DL, Drews FA, Crouch DJ. A comparison of the cell phone
driver and the drunk driver. Hum Factors. 2006;48:381-91.
24.
25.
26.
27.
28.
Lee JD, McGehee DV, Brown TL, Reyes ML. Collision warning
timing, driver distraction, and driver response to imminent rearend collisions in a high-fidelity driving simulator. Hum Factors.
2002;44(2):314-34.
29.
30.
31.
32.
33.
34.
228
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
Motor Vehicle Act [RSBC 1996, c.318] [statute on the Internet]; [cited
2015 Jul 24]. Available from: http://www.bclaws.ca/civix/document/id/
complete/statreg/96318_01.
45.
46.
Cycle Toronto. Protected bike lanes. Where, why, and what are they?
[Internet]. Toronto, ON: Cycle Toronto; [cited 2015 Jan 28]. Available
from: http://cycleto.ca/protected-bike-lanes/where-why-what.
47.
48.
Motor Vehicle Act [RSBC 1996, c.318] [statute on the Internet]; [cited
2015 Jul 24]. Available from: http://www.bclaws.ca/civix/document/id/
complete/statreg/96318_01.
49.
50.
References
51.
52.
53.
54.
Sansone RA, Sansone LA. Road rage: whats driving it? Psychiatry
(Edgmont). 2010 July;7(7):14-8.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
Appendix B
1.
2.
Where the Rubber Meets the Road: Reducing the Impact of Motor Vehicle Crashes on Health and Well-being in BC
229